Quality intervention fails to boost outcomes for HFrEF patients
A hospital and post-discharge quality improvement intervention was not associated with better outcomes among patients with heart failure with reduced ejection fraction (HFrEF), according to a new analysis published in JAMA.
Using data from the CONNECT-HF randomized clinical trial, the study's authors analyzed 5,647 patients from 161 different hospitals with a mean age of 63 years old. While 67% of patients were men, 87% presented with chronic heart failure. The intervention took place from March 2017 to March 2020.
The intervention included site-level clinician education and quality improvement strategic planning. A site-specific gap analysis and a quality improvement action plan was developed for each participating hospital. Updates were provided on a monthly basis that examined outcomes among HFrEF patients.
Hospitals were chosen at random to either implement the intervention or carry on as normal.
Overall, the authors found that the rates of rehospitalization or death were 38.6% for the quality improvement group and 39.2% for the control group.
There was also no significant difference between the two groups in the probability of reaching a higher composite quality score.
“Findings in this study demonstrate the magnitude of ongoing challenges facing hospitals and clinicians attempting to improve care for patients with heart failure,” wrote lead author Adam D. DeVore, MD, a cardiologist with the Duke Clinical Research Institute, and colleagues. “In this study, strategies of education and audit and feedback were implemented according to evidence-based strategies shown to be effective for improving both processes of care and clinical outcomes in other areas of medicine, including cardiovascular disease.”
Read the full analysis here.