Medtronic has presented results of the US outpatient heart failure clinical study which showed that implementation of a process Improvement program improved adherence to evidence-based, guideline-recommended cardiac resynchronization therapy (CRT), implantable cardioverter-defibrillator (ICD) and drug therapy.
The study demonstrates that cardiology practices implementing the process Improvement program increased use on five of seven guideline-recommended care measures. Specifically, CRT and ICD use increased by 30 and 27%, respectively, and aldosterone antagonist use increased by 25%, all compared to baseline results.
Medtronic said that the study also showed improvement on use of beta blockers and the delivery of heart failure education when practice Improvement programs were implemented. Use of angiotensin converting enzyme inhibitors or angiotensin II receptor blockers and anticoagulation for atrial fibrillation did not show improvement.
Improve HF baseline data, collected prior to any performance Improvement intervention, demonstrated inconsistencies in guideline recommended care for heart failure patients, with women and elderly particularly at risk for underutilization of lifesaving heart failure device therapies.
Medtronic said that the clinic-level analysis showed only 37% of eligible heart failure patients received a CRT device, 50% received an ICD, and 35% received aldosterone antagonist drug therapy.
The 24-month data, which were gathered after implementing the practice-specific performance improvement interventions, showed higher utilisation with CRT therapy increasing to 66%, ICD use increasing to 78% and aldosterone antagonist drug therapy increasing to 60% utilisation.
Pat Mackin, president of the cardiac rhythm disease management business and senior vice president at Medtronic, said: “Medtronic is committed to supporting research and providing solutions that will help physicians provide better quality of care for their heart failure patients. This innovative program and the clinical sites participating in Improve HF are leading the way.”
Gregg Fonarow, co-chair of the Improve HF Scientific Steering Committee and professor of cardiovascular medicine at the University of California at Los Angeles, said: “With more than five million Americans suffering from heart failure and as one of the few cardiovascular diseases on the rise, there is a clear and urgent need to close the treatment gap between heart failure guidelines and the level of care patients currently receive.
“The Improve HF study results serve as a call to action to transform heart failure care delivery in the outpatient practice setting to consistently implement guideline-driven standards of care.”