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Title: Improving Guideline Compliance in Australia With a National Percutaneous Coronary Intervention Outcomes Registry.
Austin Authors: Eccleston, David;Horrigan, Mark ;Rafter, Tony;Holt, Geoffrey;Worthley, Stephen G;Sage, Peter;Whelan, Alan;Reid, Christopher;Thompson, Peter L
Affiliation: GenesisCare, Sydney, NSW, Australia
Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
Cardiology Department, Royal Melbourne Hospital, Melbourne, Victoria, Australia
HeartCare Victoria, Melbourne, Victoria, Australia
HeartCare Partners Brisbane, Qld, Australia
Royal Adelaide Hospital Adelaide Cardiology, Adelaide, SA, Australia
Adelaide Cardiology, Adelaide, SA, Australia
HeartCare WA, Perth, WA, Australia
NHMRC Centre of Research Excellence in Cardiovascular Outcomes Improvement, Curtin University Director, CCRE Therapeutics, Monash University, Melbourne, Victoria, Australia
Cardiologist and Director of the Heart Research Institute Sir Charles Gairdner Hospital Clinical Professor of Medicine University of Western Australia Deputy Director, Harry Perkins Institute of Medical Research, Perth, WA, Australia
Austin Health, Heidelberg, Victoria, Australia
Issue Date: 28-Feb-2017 2017-12
Publication information: Heart, Lung & Circulation 2017; 26(12): 1303-1309
Abstract: Secondary prevention strategies after percutaneous coronary intervention (PCI) include statins and dual anti-platelet therapy, however there are significant gaps between guidelines and practice. Contemporary PCI practice requires comprehensive data collection to allow dynamic auditing and benchmarking of key performance and safety indices. Genesis HeartCare is Australia's largest collaborative venture of cardiologists, practising at over 40 public and private hospitals. We hypothesised that measurement and local reporting of data would improve patient outcomes through improving compliance with guideline therapies. Real-time benchmarking via a national clinical quality and outcomes register, the Genesis Cardiovascular Outcomes Registry (GCOR-PCI). GCOR-PCI prospectively collected clinical, procedural, medication and outcomes data for 6720 consecutive patients undergoing PCI from 10 private hospitals across Australia. Key performance outcomes benchmarked against the aggregated study cohort and international standards were reported to individual sites. The main outcome measure was compliance with guideline medications (statins, anti-platelet agents). Early data identified specific practice patterns associated with lower rates of statin therapy post-PCI, which led to changes in practice. Between the first and latest year of data collection there was significant improvement in the rates of statin therapy at discharge (92.1 vs. 94.4% p<0.03) and 12 months post-PCI (87.0 vs. 92.2% p<0.001) and of antiplatelet therapy at 12 months (90.7 vs. 94.3% p<0.001). This large-scale collaboration provides a platform for the development of quality improvement initiatives. Establishment of this clinical quality registry improved patient care by identifying and monitoring gaps in delivery of appropriate therapies, driving key practice change.
DOI: 10.1016/j.hlc.2017.01.008
PubMed URL: 28389196
Type: Journal Article
Subjects: Compliance.
Coronary intervention
Appears in Collections:Journal articles

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