Navigation Links
DMP for coronary heart disease: Current guidelines indicate some need for revision
Date:2/16/2011

This release is available in German.

On 7 February 2011, the German Institute for Quality and Efficiency in Health Care (IQWiG) published the results of a search update for evidence-based clinical practice guidelines on coronary heart disease (CHD). The aim of the report is to identify those recommendations from current guidelines of high methodological quality that may be relevant for the planned revision of the corresponding disease management programme (DMP). According to the results of the report, there is no compelling need for revision of any part of the DMP. However, IQWiG identified various aspects that could be supplemented and specified. This particularly applies to general measures, drug therapy, as well as the medical indication for undergoing heart catheterization.

Evidence was documented in detail

One of IQWiG's responsibilities specified by law (Social Code Book V) is to develop and issue recommendations for DMPs. In the commission now completed, which was awarded by the Federal Joint Committee (G-BA), IQWiG systematically searched for new guidelines, assessed their methodological quality, and extracted relevant recommendations on the diagnosis, treatment and rehabilitation of patients with CHD. In addition, they documented how high the guideline authors graded the robustness of the recommendations. However, the sources of the recommendations were not examined again; this is where the Institute's guideline appraisals and benefit assessments differ.

In March 2008, IQWiG had already completed the original commission awarded by the Federal Joint Committee, which the Committee had used for an update of the DMP-CHD ( ). For the original report IQWiG had searched for guidelines published between 2002 and June 2007. In the follow-up project, the results of which are now available, the search could therefore be limited to the period after June 2007.

No contradictions between the DMP and current recommendations

A total of 14 guidelines were included which contained recommendations on the treatment of chronic CHD. As the assessment showed, the recommendations in the guidelines are by and large consistent with the requirements of the DMP. No contradictions in content were found. The Director of IQWiG, Professor Dr. med. Jrgen Windeler, stresses that "patients with coronary heart disease can thus be sure that the current DMP is consistent with the current status of medical knowledge on all main points." However, the current guidelines deal with many aspects of health care in more detail than the DMP does.

The IQWiG report therefore notes a potential need for revision, in particular in the form of an extension and specification of the DMP. For example, the items "Nutritional advice", "Physical activity", and "Counselling on smoking cessation" could be described more precisely and in more detail. In addition, the comorbidities hypertension and diabetes mellitus could be dealt with as new separate items in the DMP, and the recommendations on influenza vaccination could be included. For drug therapy, too, the guidelines include recommendations going beyond the statements of the DMP-CHD with regard to the drug classes nitrates, angiotensin-converting enzyme inhibitors, aldosterone antagonists, and blood clotting inhibitors.

Regarding the medical indication for interventional therapy (revascularization of the coronary vessel), under certain preconditions a new European guideline recommends an earlier intervention in patients with a lower grade of stenosis than is recommended in the DMP. Regarding "Training programmes for insured members", the requirements of the DMP could be supplemented: patients could learn to better recognize situations in which they should call a doctor or independently take a fast-acting drug.

IQWiG cannot make any statements on the need for updating and supplementation of the current DMP concerning the included items "Definition of coronary heart disease", "Therapy goals", and "Cooperation of health care levels", as the guidelines analysed do not provide recommendations in this regard.


'/>"/>

Contact: Anna-Sabine Ernst
info@iqwig.de
49-022-135-6850
Institute for Quality and Efficiency in Health Care
Source:Eurekalert

Related medicine news :

1. New research shows innovative respiratory stress test can quickly detect significant coronary artery disease in a noninvasive setting
2. Family history is strong predictor of obstructive coronary artery disease using CCTA
3. Mass. General Hospital to create registry for coronary optical coherence tomography
4. Coronary CTA a cost-effective alternative to cardiac catheterization for the evaluation of CAD
5. The Mount Sinai Hospital Earns Highest Ratings in New York State Report on Coronary Angioplasty
6. New research shows cardiologists can quickly detect significant coronary artery disease using a non-invasive simple, short respiratory stress test
7. Link established between erectile dysfunction and calcified coronary arteries
8. Carotid artery ultrasound is an effective alternative to more invasive coronary angiography
9. New tool to rule out coronary heart disease in primary care
10. Dietary Cocoa Flavanols Improve Vascular And Blood Pressure Measures For Coronary Artery Disease Patients
11. Lower-dose heparin use during coronary procedure does not appear to reduce risk of major bleeding
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... ... October 13, 2017 , ... Ellevate Network, the leading network for professional ... action towards gender equality at their inaugural Summit in New York City in June. ... a social audience of over 3 million. To watch the Mobilize Women video, ...
(Date:10/13/2017)... VA (PRWEB) , ... October 13, 2017 , ... ... of DevOps and Agile Software Development, has been awarded a contract by the ... Blanket Purchase Agreement (BPA) aims to accelerate the enterprise use of Agile methodologies ...
(Date:10/12/2017)... Francisco, CA (PRWEB) , ... October 12, 2017 ... ... Dr. Cheng, are now treating sleep apnea using cutting-edge Oventus O2Vent ... apnea, a serious sleep disorder characterized by frequent cessation in breathing. Oral appliances ...
(Date:10/12/2017)... ... 12, 2017 , ... The American College of Medical Informatics (ACMI) will present ... the Opening Session of AMIA’s Annual Symposium in Washington, D.C. AMIA’s Annual Symposium ... Collen, a pioneer in the field of medical informatics, this prestigious award is presented ...
(Date:10/12/2017)... ... 12, 2017 , ... HMP , a leader in healthcare events and ... Eddie Digital Award for ‘Best B-to-B Healthcare Website.’ Winners were announced during the Eddie ... annual award competition recognizes editorial and design excellence across a range of sectors. This ...
Breaking Medicine News(10 mins):
(Date:9/27/2017)... Israel and NEW YORK , Sept. 27, ... with mobile health and big data solutions, today announced that its MyDario ... Please check your local TV listings for when The Dr. Oz Show ... ... season this month. ...
(Date:9/23/2017)... , Sept. 22, 2017 Janssen Biotech, ... complete response letter from the U.S. Food and Drug ... approval of sirukumab for the treatment of moderately to ... indicates additional clinical data are needed to further evaluate ... to severely active RA. ...
(Date:9/19/2017)... medical device company developing a non-invasive, robotically assisted, platform therapy that uses pulsed sound energy ... ... Jim Bertolina, PhD ... Tom Tefft ... executive Josh Stopek , PhD, who has led R&D and business development teams at ...
Breaking Medicine Technology: