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Quality management cardiology

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https://www.readbyqxmd.com/read/28797417/implications-of-coronary-artery-calcium%C3%A2-testing-for-treatment-decisions-among-statin-candidates-according-to%C3%A2-the%C3%A2-acc-aha-cholesterol-management%C3%A2-guidelines-a-cost-effectiveness-analysis
#1
REVIEW
Jonathan C Hong, Ron Blankstein, Leslee J Shaw, William V Padula, Alejandro Arrieta, Jonathan A Fialkow, Roger S Blumenthal, Michael J Blaha, Harlan M Krumholz, Khurram Nasir
This review evaluates the cost-effectiveness of using coronary artery calcium (CAC) to guide long-term statin therapy compared with treating all patients eligible for statins according to 2013 American College of Cardiology/American Heart Association cholesterol management guidelines for atherosclerotic cardiovascular disease. The authors used a microsimulation model to compare costs and effectiveness from a societal perspective over a lifetime horizon. Both strategies resulted in similar costs and quality-adjusted life years (QALYs)...
August 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28772017/an-initiative-to-improve-primary-prevention-of-cardiovascular-disease-in-adults-with-type-ii-diabetes-based-on-the-acc-aha-2013-and-ada-2016-guidelines
#2
Litzie Garza, Jean Dols, Maria Gillespie
PURPOSE: This project was designed to increase family practice clinicians' adherence to the American College of Cardiology/American Heart Association (2013) and American Diabetes Association (ADA, 2016) clinical practice guidelines for the prevention of cardiovascular disease (CVD) in 40- to 75-year-old adults with type II diabetes (DMII) through interactive education, an electronic alert, and quality improvement sessions on the treatment and management of cholesterol in a family practice primary care setting...
August 3, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28754155/magnetic-resonance-adenosine-perfusion-imaging-as-gatekeeper-of-invasive-coronary-intervention-magnet-study-protocol-for-a-randomized-controlled-trial
#3
Dominik Buckert, Simon Witzel, Maciej Cieslik, Raid Tibi, Wolfgang Rottbauer, Peter Bernhardt
BACKGROUND: Current guidelines for the diagnosis and management of patients with stable coronary artery disease (CAD) recommend functional stress testing for risk stratification prior to revascularization procedures. Cardiac magnetic resonance imaging (CMR) is a modality of choice for stress testing because of its capability to detect myocardial ischemia sensitively and specifically. Nevertheless, evidence from randomized trials evaluating a CMR-based management of stable CAD patients in comparison to a more common angiography-based approach still is limited...
July 28, 2017: Trials
https://www.readbyqxmd.com/read/28751839/the-future-of-telemedicine-for-the-management-of-heart-failure-patients-a-consensus-document-of-the-italian-association-of-hospital-cardiologists-a-n-m-c-o-the-italian-society-of-cardiology-s-i-c-and-the-italian-society-for-telemedicine-and-ehealth-digital
#4
Andrea Di Lenarda, Giancarlo Casolo, Michele Massimo Gulizia, Nadia Aspromonte, Simonetta Scalvini, Andrea Mortara, Gianfranco Alunni, Renato Pietro Ricci, Roberto Mantovan, Giancarmine Russo, Gian Franco Gensini, Francesco Romeo
Telemedicine applied to heart failure patients is a tool for recording and providing remote transmission, storage and interpretation of cardiovascular parameters and/or useful diagnostic images to allow for intensive home monitoring of patients with advanced heart failure, or during the vulnerable post-acute phase, to improve patient's prognosis and quality of life. Recently, several meta-analyses have shown that telemedicine-supported care pathways are not only effective but also economically advantageous...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28738781/the-value-of-a-new-cardiac-magnetic-resonance-imaging-protocol-in-myocardial-infarction-with-non-obstructive-coronary-arteries-minoca-a-case-control-study-using-historical-controls-from-a-previous-study-with-similar-inclusion-criteria
#5
Per Tornvall, E B Brolin, K Caidahl, K Cederlund, O Collste, M Daniel, C Ekenbäck, J Jensen, S Y-Hassan, L Henareh, C Hofman-Bang, P Lyngå, E Maret, N Sarkar, J Spaak, M Sundqvist, P Sörensson, M Ugander, S Agewall
BACKGROUND: Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) is common with a prevalence of 6% of all patients fulfilling the diagnosis of myocardial infarction. MINOCA should be considered a working diagnosis. Cardiac Magnetic Resonance (CMR) imaging has recently been suggested to be of great value to determine the cause behind MINOCA. The objectives of this paper are to describe the rationale behind the second Stockholm Myocardial Infarction with Normal Coronaries (SMINC-2) study and to discuss the protocol for investigation of MINOCA patients in the light of the recently published position paper from the European Society of Cardiology...
July 24, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28722339/structured-pain-management-reduces-patient-discomfort-after-catheter-ablation-and-rhythm-device-surgery
#6
M Dörschner, A Bollmann, B Dinov, S Richter, M Döring, A Arya, A Müssigbrodt, S Kircher, N Dagres, P Sommer, G Hindricks, K Bode
BACKGROUND: The goal was to test the effectiveness of a structured pain management programme after invasive electrophysiological interventions in cardiology including ablation of atrial fibrillation (AF) or ventricular tachycardia (VT) and implantation, or explantation, of pacemakers or implantable cardioverter defibrillators. METHODS: This was a prospective study with a pre-/post-design where a post-intervention group (116 consecutive patients) was compared to a pre-intervention group (102 consecutive patients) after implementation of a structured pain-management programme using the numeric rating scale (NRS 0-10) and classified as moderate-to-severe if NRS > 3...
July 18, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28702947/initial-validation-of-a-healthcare-needs-scale-for-young-people-with-congenital-heart-disease
#7
Chi-Wen Chen, Ciao-Lin Ho, Wen-Jen Su, Jou-Kou Wang, Hung-Tao Chung, Pi-Chang Lee, Chun-Wei Lu, Be-Tau Hwang
AIM: To validate the initial psychometric properties of a Healthcare Needs Scale for Youth with Congenital Heart Disease. BACKGROUND: As the number of patients with congenital heart disease surviving to adulthood increases, the transitional healthcare needs for adolescents and young adults with congenital heart disease require investigation. However, few tools comprehensively identify the healthcare needs of youth with congenital heart disease. DESIGN: A cross-sectional study was employed to examine the psychometric properties of the Healthcare Needs Scale for Youth with Congenital Heart Disease...
July 12, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28682031/-the-peritoneal-ultrafiltration-in-patients-with-cardio-renal-disease
#8
Roberto Corciulo, Simone Corciulo
In Italy, the congestive heart failure is the leading cause of hospitalization and despite advances in therapy, the long-term prognosis is poor. Congestive heart failure is associated with advanced varying degrees of chronic renal disease that identify the cardio-renal syndrome type 2. High-dose diuretic therapy often fail to solve the water overload that is frequently the cause of death. The resistance to diuretics aggravates the state of the patient's edema and consequently morbidity and mortality. In the acute stage, the extracorporeal ultrafiltration unable to repair over hydration but needs frequent access weekly or midweek at the dialysis center...
March 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28660783/interview-with-justin-davies-and-andrew-tochterman
#9
Justin Davies, Andrew Tochterman
Justin Davies and Andrew Tochterman speak to Adam Price-Evans, Commissioning Editor of Future Cardiology: Justin Davies is a Senior Research Fellow and Honorary Consultant Cardiologist at the National Heart and Lung Institute, Imperial College London (UK). His main research interests include the development and application of pioneering technologies in engineering to aid understanding of disease mechanisms, and in the diagnosis of pathological disease states. After completing his undergraduate training at Imperial College, he was awarded a prestigious British Heart Foundation research fellowship to undertake his PhD at Imperial College...
July 2017: Future Cardiology
https://www.readbyqxmd.com/read/28660735/impact-of-standardized-clinical-assessment-and-management-plans-on-resource-utilization-and-costs-in-children-after-the-arterial-switch-operation
#10
Rahul H Rathod, Brittney Jurgen, Rose A Hamershock, Kevin G Friedman, Audrey C Marshall, Mihail Samnaliev, Dionne A Graham, Kathy Jenkins, James E Lock, Andrew J Powell
BACKGROUND: Standardized Clinical Assessment and Management Plans (SCAMPs) are a quality improvement initiative designed to reduce unnecessary utilization, decrease practice variation, and improve patient outcomes. We created a novel methodology, the SCAMP managed episode of care (SMEOC), which encompasses multiple encounters to assess the impact of the arterial switch operation (ASO) SCAMP on total costs. METHODS: All ASO SCAMP patients (dates March 2009 to July 2015) were compared to a control group of ASO patients (January 2001 to February 2009)...
June 28, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28651850/effect-of-compliance-to-updated-aha-acc-performance-and-quality-measures-among-patients-with-atrial-fibrillation-on-outcome-from-japanese-multicenter-registry
#11
Taku Inohara, Takehiro Kimura, Ikuko Ueda, Nobuhiro Ikemura, Kojiro Tanimoto, Nobuhiro Nishiyama, Yoshiyasu Aizawa, Takahiko Nishiyama, Yoshinori Katsumata, Keiichi Fukuda, Seiji Takatsuki, Shun Kohsaka
Performance measures (PMs) are used to accelerate translation of scientific evidence into clinical practice. However, it remains unknown how they are applied in the real world and whether the compliance to these metrics will lead to improved patient's outcome in atrial fibrillation (AF). Within the Japanese multicenter AF registry (n = 1,874), adherence of the AF PMs (based on 2016 American Heart Association/American College of Cardiology criteria) and its association with quality of life scaling and clinical outcomes was evaluated...
May 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28644179/improving-heart-failure-patient-outcomes-utilizing-guideline-directed-therapy
#12
Beth Towery Davidson, Terri Lynn Allison
Heart failure (HF) prevalence continues to rise and remains a significant burden to patients, caregivers, providers, and the healthcare system. Guideline-directed medical therapy with standard neurohormonal blockade has been the cornerstone of medical management for many years. Despite aggressive utilization of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, and aldosterone antagonists, HF hospitalizations and readmissions are common and residual mortality remains high...
July 21, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28604599/nutritional-challenges-in-duchenne-muscular-dystrophy
#13
REVIEW
Simona Salera, Francesca Menni, Maurizio Moggio, Sophie Guez, Monica Sciacco, Susanna Esposito
Neuromuscular diseases (NMDs) represent a heterogeneous group of acquired or inherited conditions. Nutritional complications are frequent in NMDs, but they are sometimes underestimated. With the prolongation of survival in patients with NMDs, there are several nutritional aspects that are important to consider, including the deleterious effects of overnutrition on glucose metabolism, mobility, and respiratory and cardiologic functions; the impact of hyponutrition on muscle and ventilatory function; constipation and other gastrointestinal complications; chewing/swallowing difficulties with an increased risk of aspiration that predisposes to infectious diseases and respiratory complications; as well as osteoporosis with an associated increased risk of fractures...
June 10, 2017: Nutrients
https://www.readbyqxmd.com/read/28587606/quality-of-anticoagulation-management-with-warfarin-among-outpatients-in-a-tertiary-hospital-in-addis-ababa-ethiopia-a-retrospective-cross-sectional-study
#14
Teferi Gedif Fenta, Tamrat Assefa, Bekele Alemayehu
BACKGROUND: Warfarin is the most widely used anticoagulant in the world. The difficulty of managing warfarin contributes to great potential for patient harm, both from excessive anticoagulation and insufficient anticoagulation. This study assessed the International Normalized Ratio (INR) control outcome measures and warfarin dose adjustment practices at cardiology and hematology outpatient clinics at a teaching hospital in Addis Ababa, Ethiopia. METHODS: The study was based on a cross - sectional study design involving 360 retrospective patients' chart review among outpatients who received warfarin for its various indications...
June 6, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28574530/quality-of-care-of-hospitalized-infective-endocarditis-patients-report-from-a-tertiary-medical-center
#15
Mohammad Amin Kashef, Jennifer Friderici, Jaime Hernandez-Montfort, Auras R Atreya, Peter Lindenauer, Tara Lagu
OBJECTIVE: There have been no recent studies describing the management and outcomes of patients with infective endocarditis (IE). PATIENTS AND METHODS: We conducted a retrospective cohort study of adult patients admitted to a tertiary medical center from 2007 to 2011 with a Duke criteria consistent discharge diagnosis of IE. We examined concordance with guideline recommendations. Outcomes included embolic events, inhospital and 1-year mortality, length of stay (LOS) and cardiac surgery...
June 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28569337/the-assessment-of-the-complexity-of-care-through-the-clinical-nursing-information-system-in-clinical-practice-a-study-protocol
#16
C Bravetti, A Cocchieri, F D'Agostino, R Alvaro, M Zega
BACKGROUND: The costs of nursing staff amounts to approximately 50% of the total budget of the health workforce and accounts for 20% to 30% of the total costs incurred by the health care companies. The goal of the study, by analyzing the complexity of care, is to provide a quantification of the assistance delivered, through the assessment of the technical aspects of the welfare activities according to the variable of time. Data from these activities flow into the clinical nursing information system Professional Assessment Instrument - PAI - which is used at the health facility involved in this study...
July 2017: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/28569290/novel-combined-management-approaches-to-patients-with-diabetes-chronic-kidney-disease-and-cardiovascular-disease
#17
J Spaak
Most patients we care for today suffer from more than one chronic disease, and multimorbidity is a rapidly growing challenge. Concomitant cardiovascular disease, renal dysfunction and diabetes represent a large proportion of all patients in cardiology, nephrology and diabetology. These entities commonly overlap due to their negative effects on vascular function and an accelerated atherosclerosis progression. At the same time, a progressive subspecialisation has caused the cardiologist to treat 'only' the heart, nephrologists 'only' the kidneys and endocrinologists' 'only' diabetes...
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28506476/adherence-to-lipid-management-guidelines-is-associated-with-lower-mortality-and-major-adverse-limb-events-in-patients-undergoing-revascularization-for-chronic-limb-threatening-ischemia
#18
Thomas F X O'Donnell, Sarah E Deery, Jeremy D Darling, Katie E Shean, Murray A Mittleman, Gabrielle N Yee, Matthew R Dernbach, Marc L Schermerhorn
OBJECTIVE: The 2013 American College of Cardiology/American Heart Association lipid management guidelines recommend high-intensity statins for all patients ≤75 years old with chronic limb-threatening ischemia (CLTI) and moderate-intensity statins for CLTI patients >75 years old without contraindications or on dialysis, but these recommendations are based primarily on coronary and stroke data. We aimed to validate these guidelines in patients with CLTI and to assess current adherence to these recommendations...
August 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28472598/supportive-cardiology-moving-palliative-care-upstream-for-patients-living-with-advanced-heart-failure
#19
Warren Harris Lewin, Wendy Cheung, A Nina Horvath, Shana Haberman, Archna Patel, Dorothy Sullivan
Heart failure (HF) affects ∼600,000 Canadians and is a chronic, life-limiting illness marked by exacerbations of distressing symptoms requiring acute medical management, typically sought in Canada's emergency departments. HF often has an unpredictable illness trajectory and is a chronic terminal illness with a poor prognosis. Patients living with advanced HF have difficulty in accessing palliative care (PC) supports, which can result in unnecessary suffering as their HF progresses and they near end of life (EOL)...
May 4, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28457812/the-recalcar-project-healthcare-in-the-cardiology-units-of-the-spanish-national-health-system-2011-to-2014
#20
Andrés Íñiguez Romo, Vicente Bertomeu Martínez, Luis Rodríguez Padial, Manuel Anguita Sánchez, Francisco Ruiz Mateas, Rafael Hidalgo Urbano, José Luis Bernal Sobrino, Cristina Fernández Pérez, Carlos Macaya de Miguel, Francisco Javier Elola Somoza
The RECALCAR project (Spanish acronym for Resources and Quality in Cardiology Units) uses 2 data sources: a survey of cardiology units and an analysis of the Minimum Basic Data set of all hospital discharges of the Spanish National Health System. From 2011 to 2014, there was marked stability in all indicators of the availability, utilization, and productivity of cardiology units. There was significant variability between units and between the health services of the autonomous communities. There was poor implementation of process management (only 14% of the units) and scarce development of health care networks (17%)...
April 27, 2017: Revista Española de Cardiología
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