Outcomes/Effectiveness Research

Following recommended guidelines to manage cardiovascular disease improves patient outcomes

Much progress has been made in the treatment of cardiovascular disease (CVD). Despite this, CVD has remained the leading cause of death and disability in the United States due to the aging population and combined epidemics of obesity and diabetes. The more recommended clinical guideline practices that physicians follow to manage cardiovascular disease, the better their patient outcomes, concludes a new study.

The researchers conducted a comprehensive analysis of studies of the use of clinical performance measures derived from clinical practice guidelines and CVD outcomes. Mortality rates were lower among CVD patients who received evidence-based medications at optimal doses compared with patients who were not given evidence-based medications or who took them at suboptimal doses. Also, decreased mortality was proportional to the number of appropriate therapies received (of all possible indicated therapies). Patients who received all indicated treatments were likely to have lower mortality rates than those who received few or no such therapies. Furthermore, a change in compliance with guideline recommendations was associated inversely with a change in mortality.

This review offers evidence that higher quality of care, as documented by clinical guideline-based performance measures, improves survival in patients with CVD. However, many patients still do not receive optimal care resulting in deaths that could be prevented, conclude the researchers. Their study was supported in part by the Agency for Healthcare Research and Quality (HS10548).

See "Performance measures have a major effect on cardiovascular outcomes: A review," by Rajendra H. Mehta, M.D., M.S., Eric D. Peterson, M.D., M.P.H, and Robert M. Califf, M.D., in the May 2007 American Journal of Medicine 120, pp. 398-402.

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