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Cluster-randomized ...
Cluster-randomized trial to evaluate the effects of a quality improvement program on management of non-ST-elevation acute coronary syndromes : The European Quality Improvement Programme for Acute Coronary Syndromes (EQUIP-ACS)
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Flather, Marcus D. (author)
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Babalis, Daphne (author)
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Booth, Jean (author)
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Bardaji, Alfredo (author)
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Machecourt, Jacques (author)
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Opolski, Grzegorz (author)
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Ottani, Filippo (author)
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Bueno, Hector (author)
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Banya, Winston (author)
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Brady, Anthony R. (author)
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Bojestig, Mats (author)
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- Lindahl, Bertil (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Institutionen för medicinska vetenskaper
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(creator_code:org_t)
- Elsevier BV, 2011
- 2011
- English.
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In: American Heart Journal. - : Elsevier BV. - 0002-8703 .- 1097-6744. ; 162:4, s. 700-707.e1
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Background Registries have shown that quality of care for acute coronary syndromes (ACS) often falls below the standards recommended in professional guidelines. Quality improvement (QI) is a strategy to improve standards of clinical care for patients, but the efficacy of QI for ACS has not been tested in randomized trials. Methods We undertook a prospective, cluster-randomized, multicenter, multinational study to evaluate the efficacy of a QI program for ACS. Participating centers collected data on consecutive admissions for non-ST-elevation ACS for 4 months before the QI intervention and 3 months after. Thirty-eight hospitals in France, Italy, Poland, Spain, and the United Kingdom were randomized to receive the QI program or not, 19 in each group. We measured 8 in-hospital quality indicators (risk stratification, coronary angiography, anticoagulation, beta-blockers, statins, angiotensin-converting enzyme inhibitors, and clopidogrel loading and maintenance) before and after the intervention and compared composite changes between the QI and non-QI groups. Results A total of 2604 patients were enrolled. The absolute overall change in use of quality indicators in the QI group was 8.5% compared with 0.8% in the non-QI group (odds ratio for achieving a quality indicator in QI versus non-QI 1.66, 95% CI 1.43-1.94; P < .001). The main changes were observed in the use of risk stratification and clopidogrel loading dose. Conclusions The QI strategy resulted in a significant improvement in the quality indicators measured. This type of QI intervention can lead to useful changes in health care practice for ACS in a wide range of settings.
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- art (subject category)
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- By the author/editor
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Flather, Marcus ...
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Babalis, Daphne
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Booth, Jean
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Bardaji, Alfredo
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Machecourt, Jacq ...
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Opolski, Grzegor ...
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show more...
-
Ottani, Filippo
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Bueno, Hector
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Banya, Winston
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Brady, Anthony R ...
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Bojestig, Mats
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Lindahl, Bertil
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show less...
- Articles in the publication
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American Heart J ...
- By the university
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Uppsala University