In-Hospital Outcomes for Nonadherent Patients with HF

• Medication and dietary nonadherence are precipitating factors for HF hospitalization.
• Predischarge identification of patients with risk factors for nonadherence may provide opportunities to target preventable admissions through disease management.
• The Get With The Guidelines-Heart Failure (GWTG-HF) program may enhance evidence-based care by documenting the rates of compliance for nonadherent patients and by providing clinicians with real-time guideline reminders.

Treatment and Risks of HF: Gaps in Evidence or Quality?

• Angiotensin Converting Enzyme (ACE)-Inhibitors or angiotensin receptor blockers (ARBs) and beta blockers reduce morbidity and mortality in patients with heart failure (HF) and left ventricular systolic dysfunction (LVSD).
• The use of evidence-based therapies such as ACE-Inhibitors, ARBs and beta blockers in patients with HF and LVSD is significantly lower in those at risk.
• In order to optimize the use of evidence-based therapies and improve HF outcomes, more data are needed to assess how to safely treat high-risk patients with contraindications.

Early Physician Follow up and Readmission Rates for HF Among Beneficiaries

• Readmission rates after hospitalization for heart failure (HF) among Medicare beneficiaries are high.
• The research shows that follow-up after discharge varies significantly among hospitals, and for many patients does not occur in a timely manner.
• These findings support a need for guidelines recommending more uniform post-discharge systems of care.

Racial and Ethnic Differences in the Treatment of Acute Myocardial Infarction

• Research suggests differences in the use of evidence-based process performance among racial/ethnic groups.
• Minorities with acute coronary syndrome are less likely than Caucasians to receive evidence-based care and are more likely to be treated at facilities with lower adherence to composite measures.1
• Quality improvement programs may enhance hospital adherence to care guidelines and patients’ acute and long term outcomes thereby improving ethnic and racial disparities in MI care.

1.  Peterson ED, Shaw LK, DeLong ER, Pryor DB, Califf RM, Mark DB. Racial variation in the use of coronary-revascularization procedures. Are the differences real? Do they matter? N Engl J Med. 1997;336:480-486.