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Current quality of cardiovascular prevention for Million Hearts: an analysis of 147,038 outpatients from The Guideline Advantage.

Publication ,  Journal Article
Eapen, ZJ; Liang, L; Shubrook, JH; Bauman, MA; Bufalino, VJ; Bhatt, DL; Peterson, ED; Hernandez, AF
Published in: Am Heart J
September 2014

BACKGROUND: Million Hearts is a national initiative to prevent 1 million heart attacks and strokes over 5 years. The degree to which outpatient providers are controlling risk factors has not been fully described. METHODS: We examined adherence to the Million Hearts clinical quality measures using The Guideline Advantage, a nationwide quality improvement program for outpatient care. Specifically, we determined the proportion of patients with (1) ischemic vascular disease who were prescribed an antiplatelet drug; (2) hypertension whose blood pressure was controlled; (3) diabetes mellitus whose most recent low-density lipoprotein cholesterol level was <100 mg/dL; and 4) a tobacco use screening and who received a smoking cessation intervention as needed. RESULTS: From January 1, 2010, to March 31, 2012, there were 147,038 patients enrolled from 25 US practices. At the practice level, antiplatelet prescription ranged from 50.0% to 82.3% (median 71.9%, interquartile range [IQR] 66.7-82.1), hypertension control ranged from 48.6% to 75.3% (median 66.6%, IQR 60.1-70.9), hyperlipidemia control among patients with diabetes mellitus ranged from 53.3% to 100.0% (median 75.8%, IQR 65.8-83.0), and tobacco use screening and intervention ranged from 31.0% to 98.8% (median 79.8%, IQR 72.0-83.2). Black and people of color races were associated with a lower likelihood of blood pressure control and cholesterol control. Female gender was associated with a lower likelihood of antiplatelet prescription and cholesterol control. CONCLUSIONS: Compliance with quality measures for the Million Hearts initiative varies widely and is notable for racial and gender disparities. Our findings identify multiple opportunities to improve the quality of cardiovascular prevention.

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Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

September 2014

Volume

168

Issue

3

Start / End Page

398 / 404

Location

United States

Related Subject Headings

  • Stroke
  • Quality Improvement
  • Practice Guidelines as Topic
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Health Promotion
  • Health Behavior
  • Guideline Adherence
 

Citation

APA
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ICMJE
MLA
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Eapen, Z. J., Liang, L., Shubrook, J. H., Bauman, M. A., Bufalino, V. J., Bhatt, D. L., … Hernandez, A. F. (2014). Current quality of cardiovascular prevention for Million Hearts: an analysis of 147,038 outpatients from The Guideline Advantage. Am Heart J, 168(3), 398–404. https://doi.org/10.1016/j.ahj.2014.06.007
Eapen, Zubin J., Li Liang, Jay H. Shubrook, Mary A. Bauman, Vincent J. Bufalino, Deepak L. Bhatt, Eric D. Peterson, and Adrian F. Hernandez. “Current quality of cardiovascular prevention for Million Hearts: an analysis of 147,038 outpatients from The Guideline Advantage.Am Heart J 168, no. 3 (September 2014): 398–404. https://doi.org/10.1016/j.ahj.2014.06.007.
Eapen ZJ, Liang L, Shubrook JH, Bauman MA, Bufalino VJ, Bhatt DL, et al. Current quality of cardiovascular prevention for Million Hearts: an analysis of 147,038 outpatients from The Guideline Advantage. Am Heart J. 2014 Sep;168(3):398–404.
Eapen, Zubin J., et al. “Current quality of cardiovascular prevention for Million Hearts: an analysis of 147,038 outpatients from The Guideline Advantage.Am Heart J, vol. 168, no. 3, Sept. 2014, pp. 398–404. Pubmed, doi:10.1016/j.ahj.2014.06.007.
Eapen ZJ, Liang L, Shubrook JH, Bauman MA, Bufalino VJ, Bhatt DL, Peterson ED, Hernandez AF. Current quality of cardiovascular prevention for Million Hearts: an analysis of 147,038 outpatients from The Guideline Advantage. Am Heart J. 2014 Sep;168(3):398–404.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

September 2014

Volume

168

Issue

3

Start / End Page

398 / 404

Location

United States

Related Subject Headings

  • Stroke
  • Quality Improvement
  • Practice Guidelines as Topic
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Health Promotion
  • Health Behavior
  • Guideline Adherence