Effect of Compliance to Updated AHA/ACC Performance and Quality Measures Among Patients With Atrial Fibrillation on Outcome (from Japanese Multicenter Registry)

Taku Inohara, Takehiro Kimura, Ikuko Ueda, Nobuhiro Ikemura, Kojiro Tanimoto, Nobuhiro Nishiyama, Yoshiyasu Aizawa, Takahiko Nishiyama, Yoshinori Katsumata, Keiichi Fukuda, Seiji Takatsuki, Shun Kosaka

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Performance measures (PMs) are used to accelerate translation of scientific evidence into clinical practice. However, it remains unknown how they are applied in the real world and whether the compliance to these metrics will lead to improved patient's outcome in atrial fibrillation (AF). Within the Japanese multicenter AF registry (n = 1,874), adherence of the AF PMs (based on 2016 American Heart Association/American College of Cardiology criteria) and its association with quality of life scaling and clinical outcomes was evaluated. The patient was deemed "adherent" when all applicable components of the PMs for outpatient settings (CHA2DS2-VASc risk score documentation [PM-4], anticoagulation prescribed [PM-5], and monthly international normalized ratio (INR) for warfarin treatment [PM-6]) were satisfied. The Atrial Fibrillation Effect on Quality of Life (AFEQT) questionnaire was assessed at baseline and 1 year. About a half of patients (46.1%) were adherent to the AF PMs. PMs were more frequently achieved in patients managed with rhythm control compared with rate control. The achievement rate for each component was 53.9% for PM-4, 85.6% for PM-5, and 90.3% for PM-6, respectively. Although AFEQT global scores at baseline were similar (median 79.2 [interquartile ranges 66.7 to 88.5] vs 77.1 [64.8 to 88.0], p = 0.227), AFEQT global scores at 1-year follow-up were significantly greater in adherence group than those in nonadherence group (89.2 [78.5 to 96.6] vs 86.7 [76.7 to 95.0], p = 0.021). This tendency was consistent regardless of therapeutic strategies. There remains an important opportunity to improve the quality of care in patients with AF. Adherence to the AF PMs might lead to the improvement of patient's quality of life.

Original languageEnglish
JournalAmerican Journal of Cardiology
DOIs
Publication statusAccepted/In press - 2017

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Atrial Fibrillation
Compliance
Registries
Quality of Life
International Normalized Ratio
Quality of Health Care
Warfarin
Documentation
Outpatients
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Effect of Compliance to Updated AHA/ACC Performance and Quality Measures Among Patients With Atrial Fibrillation on Outcome (from Japanese Multicenter Registry). / Inohara, Taku; Kimura, Takehiro; Ueda, Ikuko; Ikemura, Nobuhiro; Tanimoto, Kojiro; Nishiyama, Nobuhiro; Aizawa, Yoshiyasu; Nishiyama, Takahiko; Katsumata, Yoshinori; Fukuda, Keiichi; Takatsuki, Seiji; Kosaka, Shun.

In: American Journal of Cardiology, 2017.

Research output: Contribution to journalArticle

Inohara, Taku ; Kimura, Takehiro ; Ueda, Ikuko ; Ikemura, Nobuhiro ; Tanimoto, Kojiro ; Nishiyama, Nobuhiro ; Aizawa, Yoshiyasu ; Nishiyama, Takahiko ; Katsumata, Yoshinori ; Fukuda, Keiichi ; Takatsuki, Seiji ; Kosaka, Shun. / Effect of Compliance to Updated AHA/ACC Performance and Quality Measures Among Patients With Atrial Fibrillation on Outcome (from Japanese Multicenter Registry). In: American Journal of Cardiology. 2017.
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AU - Inohara, Taku

AU - Kimura, Takehiro

AU - Ueda, Ikuko

AU - Ikemura, Nobuhiro

AU - Tanimoto, Kojiro

AU - Nishiyama, Nobuhiro

AU - Aizawa, Yoshiyasu

AU - Nishiyama, Takahiko

AU - Katsumata, Yoshinori

AU - Fukuda, Keiichi

AU - Takatsuki, Seiji

AU - Kosaka, Shun

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AB - Performance measures (PMs) are used to accelerate translation of scientific evidence into clinical practice. However, it remains unknown how they are applied in the real world and whether the compliance to these metrics will lead to improved patient's outcome in atrial fibrillation (AF). Within the Japanese multicenter AF registry (n = 1,874), adherence of the AF PMs (based on 2016 American Heart Association/American College of Cardiology criteria) and its association with quality of life scaling and clinical outcomes was evaluated. The patient was deemed "adherent" when all applicable components of the PMs for outpatient settings (CHA2DS2-VASc risk score documentation [PM-4], anticoagulation prescribed [PM-5], and monthly international normalized ratio (INR) for warfarin treatment [PM-6]) were satisfied. The Atrial Fibrillation Effect on Quality of Life (AFEQT) questionnaire was assessed at baseline and 1 year. About a half of patients (46.1%) were adherent to the AF PMs. PMs were more frequently achieved in patients managed with rhythm control compared with rate control. The achievement rate for each component was 53.9% for PM-4, 85.6% for PM-5, and 90.3% for PM-6, respectively. Although AFEQT global scores at baseline were similar (median 79.2 [interquartile ranges 66.7 to 88.5] vs 77.1 [64.8 to 88.0], p = 0.227), AFEQT global scores at 1-year follow-up were significantly greater in adherence group than those in nonadherence group (89.2 [78.5 to 96.6] vs 86.7 [76.7 to 95.0], p = 0.021). This tendency was consistent regardless of therapeutic strategies. There remains an important opportunity to improve the quality of care in patients with AF. Adherence to the AF PMs might lead to the improvement of patient's quality of life.

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