TY - JOUR
T1 - Trends in the use of evidence-based treatments for coronary artery disease among women and the elderly
T2 - Findings from the get with the guidelines quality-improvement program
AU - Lewis, William R.
AU - Ellrodt, A. Gray
AU - Peterson, Eric
AU - Hernandez, Adrian F.
AU - LaBresh, Kenneth A.
AU - Cannon, Christopher P.
AU - Pan, Wenqin
AU - Fonarow, Gregg C.
PY - 2009/11
Y1 - 2009/11
N2 - Background-Significant disparities have been reported in the application of evidence-based guidelines in the treatment of coronary artery disease (CAD) in women and the elderly. We hypothesized that participation in a quality-improvement program could improve care for all patients and thus narrow treatment gaps over time. Methods and Results-Treatment of 237 225 patients hospitalized with CAD was evaluated in the Get With the Guidelines-CAD program from 2002 to 2007. Six quality measures were evaluated in eligible patients without contraindications: Aspirin on admission and discharge, β-blockers use at discharge, angiotensin-converting enzyme inhibitor or angiotensin receptor antagonist use, lipid-lowering medication use, and tobacco cessation counseling along with other care metrics. Over time, composite adherence on these 6 measures increased from 86.5% to 97.4% (+10.9%) in men and 84.8% to 96.2% (+11.4%) in women. There was a slight difference in composite adherence by sex that remained significant over time (P<0.0001), but this was confined to patients <75 years. Composite adherence in younger patients (<75 years) increased from 87.1% to 97.7% (+10.6%) and from 83.0% to 95.1% (+12.1%) in the elderly (≥75 years) over time. Conclusions-Among hospitals participating in Get With the Guidelines-CAD, guideline adherence has improved substantially over time for both women and men and younger and older CAD patients, with only slight age and sex differences in some measures persisting.
AB - Background-Significant disparities have been reported in the application of evidence-based guidelines in the treatment of coronary artery disease (CAD) in women and the elderly. We hypothesized that participation in a quality-improvement program could improve care for all patients and thus narrow treatment gaps over time. Methods and Results-Treatment of 237 225 patients hospitalized with CAD was evaluated in the Get With the Guidelines-CAD program from 2002 to 2007. Six quality measures were evaluated in eligible patients without contraindications: Aspirin on admission and discharge, β-blockers use at discharge, angiotensin-converting enzyme inhibitor or angiotensin receptor antagonist use, lipid-lowering medication use, and tobacco cessation counseling along with other care metrics. Over time, composite adherence on these 6 measures increased from 86.5% to 97.4% (+10.9%) in men and 84.8% to 96.2% (+11.4%) in women. There was a slight difference in composite adherence by sex that remained significant over time (P<0.0001), but this was confined to patients <75 years. Composite adherence in younger patients (<75 years) increased from 87.1% to 97.7% (+10.6%) and from 83.0% to 95.1% (+12.1%) in the elderly (≥75 years) over time. Conclusions-Among hospitals participating in Get With the Guidelines-CAD, guideline adherence has improved substantially over time for both women and men and younger and older CAD patients, with only slight age and sex differences in some measures persisting.
KW - Age factors
KW - Coronary artery disease
KW - Quality control
KW - Sex
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U2 - 10.1161/CIRCOUTCOMES.108.824763
DO - 10.1161/CIRCOUTCOMES.108.824763
M3 - Article
C2 - 20031902
AN - SCOPUS:77649218992
SN - 1941-7713
VL - 2
SP - 633
EP - 641
JO - Circulation: Cardiovascular Quality and Outcomes
JF - Circulation: Cardiovascular Quality and Outcomes
IS - 6
ER -