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:2/10/2016)... ... 10, 2016 , ... Everseat has joined the award-winning Allscripts ... physicians. The integration will enable Allscripts users to post open appointments to the ... app. , The partnership gives Everseat substantial added power to help Allscripts meet ...
(Date:2/10/2016)... ... February 10, 2016 , ... Workrite Ergonomics this week announced the launch ... mounts ever. , “Our goal was to develop a product from the ground ... we have ever created.” said Darren Hulsey, Product Manager for Workrite Ergonomics. “The ...
(Date:2/10/2016)... , ... February 10, 2016 , ... Anxiety of older ... the start of Medicare Part D a decade ago, according to The Senior ... older adults on how they are coping with rapidly rising costs. “The implications ...
(Date:2/10/2016)... ... February 09, 2016 , ... ... Face and Body Specialists are delighted to welcome a new addition to their ... Face and Body Specialists as a nurse practitioner performing cosmetic procedures ...
(Date:2/10/2016)... ... February 10, 2016 , ... It’s that time of year when most ... of the Interscholastic Athletic Association of Maryland (IAAM), Hall of Fame athlete and Garrison ... are cast aside. , That’s why one of her first decisions when her IAAM ...
Breaking Medicine News(10 mins):
(Date:2/10/2016)... 10, 2016 CERS ), Medivation, Inc. ... ) and Celldex Therapeutics, Inc. (NASDAQ: CLDX ). ... Adamas Pharmaceuticals, Inc. (NASDAQ: ADMS ) and Celldex Therapeutics, ... Orphan Drug Designations become vitally important in the development of ... drugs and biologics which are defined as those intended for ...
(Date:2/10/2016)... /PRNewswire/ - The President of New Venture Medical, ... an anti-radiation product from their Research and Development ... treatment of cancer using radiation and the treating ... the healing of radiation burns, even when open ... the healthy cells from radiation damage. It selectively ...
(Date:2/10/2016)... , Feb. 10, 2016  Silicon Biosystems Menarini ... products that help uncover the biological complexities of ... Inc., a developer of innovative technologies for genomics ... partnership aimed at enabling translational researchers to obtain ... couple hundred tumor and normal cells in an ...
Breaking Medicine Technology: