Navigation Links
Health structures explain nearly 20 percent of non-adherence to heart failure guidelines
Date:9/2/2014

Barcelona, Spain Tuesday 2 September 2014: Health structures explain nearly 20% of the non-adherence to heart failure guidelines, according to the results of a joint ESC-OECD study presented today at ESC Congress by Professor Aldo Maggioni. Clinical variables explained more than 80% of non-adherence.

Professor Maggioni said: "This is a unique evaluation which combines clinical data and health structure characteristics of different countries. It provides a fuller picture of the reasons some patients with heart failure do not receive treatment according to ESC guidelines."

Heart failure affects 2-3% of the population and accounts for around 14% of cardiovascular disease related hospital admissions in Organisation for Economic Co-operation and Development (OECD) countries. Medical treatment can improve survival of patients with chronic heart failure but guidelines are often incompletely followed.

The current study analysed the impact of clinical factors and health system characteristics on adherence to guidelines in OECD countries. Three data sets were combined: the ESC EORP Heart Failure Long-Term Registry(1), the OECD Health System Characteristics Survey (2012) and the OECD Health Statistics 2013 database.

Out of the 17 901 patients in the ESC Registry, 5 304 were included in this analysis. These were patients in OECD countries who had chronic heart failure with a reduced ejection fraction, for whom there are ESC guidelines on drug therapy(2) (3). Non-adherence to the guidelines was defined as: patients not treated with at least two recommended drugs, treatment at suboptimal dosage, no documented contraindication or intolerance to recommended drugs.

The researchers found non-adherence to drug treatment in nearly 25% of patients, with a large variation within and across countries. Within countries, adherence ranged from 0-100% while across countries it ranged from 11-73%.

Professor Maggioni said: "We found that within country variation was higher than the variation across countries. Countries with a large variability in adherence to guidelines between centres need targeted approaches to improve access and quality of care. Those with low adherence overall need country-wide solutions."

When the researchers evaluated each health structure characteristic individually, they found that resource; payment and quality variables were strongly linked to adherence. For example, higher numbers of GPs per 1 000 population was associated with higher adherence to guidelines. Countries where GPs primarily worked in private practice or were paid for the services provided also had higher levels of adherence. Conversely, countries with no incentives to comply with guidelines had higher levels of non-adherence.

The researchers then conducted a multivariate analysis. They found that 18% of the variability in adherence to guidelines was explained by country health structures and the remaining 82% was accounted for by patient clinical variables. Provider incentives to comply with guidelines remained an influential factor in this analysis, although the strength of the association weakened. Patients with more advanced heart failure and comorbidities such as mitral regurgitation and COPD were more likely to receive recommended treatments.

Professor Maggioni said: "Our analysis shows that it is not only clinical factors that influence whether or not guidelines are implemented. Countries that have a specific programme to implement guidelines and that pay for them to be followed have a statistically significantly better adherence to recommended treatments."

He concluded: "The next step in the ESC's collaboration with the OECD is to see if these health structure characteristics and clinical variables are also associated with outcomes in patients with heart failure."


'/>"/>

Contact: ESC Press Office
press@escardio.org
34-670-521-210
European Society of Cardiology
Source:Eurekalert

Related medicine news :

1. Aeroflow Healthcare Opens Office In Greer, SC To Service Greenville & Spartanburg Patients
2. Avon Healthcare Upgrades to NOVAtime 4000 Time and Attendance / Workforce Management Solution with NT7000 Smart Clocks
3. Harmonica Techs, Inventor of the Pulmonica Pulmonary Harmonica, Outlines New Uses for Harmonicas in Healthcare
4. National Association of Professional Women Announces Victoria Smith, Office Manager at Apex Healthcare, LLC, a 2014 Professional Woman of the Year
5. Pro Player Health Alliance Confirms Big Name Speakers at 2015 American Sleep and Breathing Academy Conference
6. Family dinners good for teens mental health, could protect from cyberbullying
7. Bioavailability Vs Absorption - NutriGold Publishes Tips to Help Consumers Make Informed Decisions for Their Health
8. Hands On HealthCare Massage Therapy and Wellness Day Spa Announces Fundraising and Raising Awareness of Childhood Cancer
9. Healthy Grid: Fight Cavities With Sweet Treats
10. Powerhouse EHR, Future Health, Announces Gold Sponsorship of POWERPlay in Sports National Tour
11. USHEALTH Advisors, LLC Continues Its Record-Setting Sales Pace
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... LEXINGTON, Ky. (PRWEB) , ... October 13, 2017 , ... ... MD, MPH to become its next President and Chief Executive Officer, succeeding Dr. James ... and CEO Elect beginning July 1, 2018 until Dr. Puffer’s retirement at the end ...
(Date:10/13/2017)... ... 2017 , ... Apple Rehab Shelton Lakes , which specializes in the ... facility as part of a disaster drill on October 3rd. , Apple Rehab participated ... Emergency Manager, as well as the Connecticut Long Term Care Mutual Aid Plan ...
(Date:10/13/2017)... ... 2017 , ... Yisrayl Hawkins, Pastor and Overseer at The House of Yahweh, ... and least understood books in the Holy Scriptures, Revelation. The Book of Revelation paints ... for centuries. Many have tossed it off as mere rubbish, but Yisrayl Hawkins says ...
(Date:10/12/2017)... WILMINGTON, Del. (PRWEB) , ... October 12, 2017 ... ... technology and advisory services for healthcare compliance program management, will showcase a range ... and National Association for Assisted Living (NCAL) Convention and Expo to be held ...
(Date:10/12/2017)... (PRWEB) , ... October 12, 2017 , ... The American ... Excellence to Carol Friedman, PhD, FACMI, during the Opening Session of AMIA’s Annual Symposium ... 8. , In honor of Morris F. Collen, a pioneer in the field of ...
Breaking Medicine News(10 mins):
(Date:9/18/2017)... ALLENTOWN , Pa. and KALAMAZOO, Mich. ... Allentown, Penn. , and OptiMed Specialty Pharmacy ... a business partnership to offer a strategic hub service ... PMD Healthcare,s highly sought-after personal spirometer, Spiro PD 2.0, ... A spirometer is a medical device used ...
(Date:9/12/2017)... , Sept. 12, 2017   EcoVadis , the leading platform for ... the first annual edition of its Global CSR Risk and Performance Index. ... by EcoVadis, based on Scorecard Ratings that analyzed nearly 800,000 data points ... ... ...
(Date:9/9/2017)... , Sept. 8, 2017 ... Mobile MRI Unit coming to Washington DC ... When: Tuesday, September 12 th – Monday, September ... Washington, D.C. offering free MRI brain scans to the public.Where:  ... will be parked at 501 K Street NW, Washington, D.C.What:BTF brings its ...
Breaking Medicine Technology: