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Health Status Variation Across Practices in Outpatients With Heart Failure: Insights From the CHAMP-HF (Change the Management of Patients With Heart Failure) Registry.

Publication ,  Journal Article
Khariton, Y; Hernandez, AF; Fonarow, GC; Sharma, PP; Duffy, CI; Thomas, L; Mi, X; Albert, NM; Butler, J; McCague, K; Nassif, ME; Williams, FB ...
Published in: Circ Cardiovasc Qual Outcomes
April 2018

BACKGROUND: Although a key treatment goal for patients with heart failure with reduced ejection fraction is to optimize their health status (their symptoms, function, and quality of life), the variability across outpatient practices in achieving this goal is unknown. METHODS AND RESULTS: In the CHAMP-HF (Change the Management of Patients With Heart Failure) registry, associations between baseline practice characteristics and Kansas City Cardiomyopathy Questionnaire (KCCQ) Overall Summary (OS) and Symptom Frequency (SF) scores were assessed in 3494 patients across 140 US practices using hierarchical regression after accounting for 23 patient and 11 treatment characteristics. We then calculated an adjusted median odds ratio to quantify the average difference in likelihood that a patient would have excellent (KCCQ-OS, ≥75) health status or minimal (monthly or fewer) symptoms (KCCQ-SF, ≥75) when treated at one practice versus another, at random. The mean (±SD) KCCQ-OS and KCCQ-SF were 64.2±24 and 68.9±25.6, with 40% (n=1380) and 50% (n=1760) having KCCQ scores ≥75, respectively. The adjusted median odds ratio across practices, for KCCQ-OS ≥75, was 1.70 (95% confidence interval, 1.54-1.99; P<0.001) indicating a median 70% higher odds of a patient having good-to-excellent health status when treated at one random practice versus another. In regard to KCCQ-SF, the adjusted median odds ratio for KCCQ-SF ≥75 was 1.54 (95% confidence interval, 1.41-1.76; P=0.001). CONCLUSIONS: In a large, contemporary registry of outpatients with chronic heart failure with reduced ejection fraction, we observed significant practice-level variability in patients' health status. Quantifying patients' health status as a measure of quality should be explored as a foundation for improving care. CLINICAL TRIAL REGISTRATION: URL: https://www.centerwatch.com. Unique identifier: TX144901.

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Published In

Circ Cardiovasc Qual Outcomes

DOI

EISSN

1941-7705

Publication Date

April 2018

Volume

11

Issue

4

Start / End Page

e004668

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • United States
  • Treatment Outcome
  • Time Factors
  • Surveys and Questionnaires
  • Stroke Volume
  • Risk Factors
  • Risk Assessment
  • Registries
  • Recovery of Function
 

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Khariton, Y., Hernandez, A. F., Fonarow, G. C., Sharma, P. P., Duffy, C. I., Thomas, L., … Spertus, J. A. (2018). Health Status Variation Across Practices in Outpatients With Heart Failure: Insights From the CHAMP-HF (Change the Management of Patients With Heart Failure) Registry. Circ Cardiovasc Qual Outcomes, 11(4), e004668. https://doi.org/10.1161/CIRCOUTCOMES.118.004668
Khariton, Yevgeniy, Adrian F. Hernandez, Gregg C. Fonarow, Puza P. Sharma, Carol I. Duffy, Laine Thomas, Xiaojuan Mi, et al. “Health Status Variation Across Practices in Outpatients With Heart Failure: Insights From the CHAMP-HF (Change the Management of Patients With Heart Failure) Registry.Circ Cardiovasc Qual Outcomes 11, no. 4 (April 2018): e004668. https://doi.org/10.1161/CIRCOUTCOMES.118.004668.
Khariton Y, Hernandez AF, Fonarow GC, Sharma PP, Duffy CI, Thomas L, et al. Health Status Variation Across Practices in Outpatients With Heart Failure: Insights From the CHAMP-HF (Change the Management of Patients With Heart Failure) Registry. Circ Cardiovasc Qual Outcomes. 2018 Apr;11(4):e004668.
Khariton, Yevgeniy, et al. “Health Status Variation Across Practices in Outpatients With Heart Failure: Insights From the CHAMP-HF (Change the Management of Patients With Heart Failure) Registry.Circ Cardiovasc Qual Outcomes, vol. 11, no. 4, Apr. 2018, p. e004668. Pubmed, doi:10.1161/CIRCOUTCOMES.118.004668.
Khariton Y, Hernandez AF, Fonarow GC, Sharma PP, Duffy CI, Thomas L, Mi X, Albert NM, Butler J, McCague K, Nassif ME, Williams FB, DeVore A, Patterson JH, Spertus JA. Health Status Variation Across Practices in Outpatients With Heart Failure: Insights From the CHAMP-HF (Change the Management of Patients With Heart Failure) Registry. Circ Cardiovasc Qual Outcomes. 2018 Apr;11(4):e004668.

Published In

Circ Cardiovasc Qual Outcomes

DOI

EISSN

1941-7705

Publication Date

April 2018

Volume

11

Issue

4

Start / End Page

e004668

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • United States
  • Treatment Outcome
  • Time Factors
  • Surveys and Questionnaires
  • Stroke Volume
  • Risk Factors
  • Risk Assessment
  • Registries
  • Recovery of Function