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Increasing guideline adherence in the management of acute coronary syndrome (ACS) in hospitals potentially reduces heart failure and mortality. Therefore, an expert panel identified three guideline recommendations as the most important aims for improvement in ACS care, i.e. timely invasive treatment, use of risk scoring instruments and prescription of secondary prevention medication at discharge.
This study aims to evaluate in-hospital guideline adherence in the care of patients diagnosed with ACS and to identify associated factors.
The study has a cross-sectional design. Data are collected in 13 hospitals in the Netherlands by means of retrospective chart review of patients discharged in 2012 with a diagnosis of ACS. The primary outcomes will be the percentages of patients receiving timely invasive treatment, with a documented cardiac risk score, and with a prescription of the guideline-recommended discharge medication. In addition, factors associated with guideline adherence will be studied using generalised linear (mixed) models.
This study explores guideline adherence in Dutch hospitals in the management of patients diagnosed with ACS, using a data source universally available in hospitals. The results of this study can be informative for professionals involved in ACS care as they facilitate targeted improvement efforts.
Braunwald E, Mark DB, Jones RH, et al. Unstable angina: diagnosis and management. Clinical practice guideline number 10, publication 94–0602. Rockville, MD: Agency for Health Care Policy and Research and the National Heart, Lung, and Blood Institute, US Public Health Service, US Department of Health and Human Services; 1994.
Boyer NM, Laskey WK, Cox M, et al. Trends in clinical, demographic, and biochemical characteristics of patients with acute myocardial infarction from 2003 to 2008: a report from the American Heart Association Get With The Guidelines coronary artery disease program. J Am Heart Assoc. 2012;1(4):e001206. PubMedCentralPubMedCrossRef
VMS veiligheidsprogramma [VMS safety management program] [Internet] 2013. Available from: www.vmszorg.nl.
Dutch Health Insurance Counsil. Pharmacotherapeutic Compass. 2012 [updated 2012 Jan 1]. Available from: http://www.fk.cvz.nl/.
Rubin DB. Inference and missing data. Biometrika. 1976;63(3):581–92. CrossRef
Van Buuren S, Groothuis-Oudshoorn K. Mice: Multivariate Imputation by Chained Equations in R. J Stat Softw. 2011;45(3):1–67.
Maas CJM, Hox JJ. Sufficient sample sizes for multilevel modeling. Methodology. 2005;1(3):86–92.
De Blok C, Koster E, Schilp J, et al. Implementatie VMS veiligheidsprogramma [Implementation of the Dutch national patient safety program]. Utrecht: NIVEL and EMGO+Institute; 2013.
- Monitoring guideline adherence in the management of acute coronary syndrome in hospitals: design of a multicentre study
I. van der Wulp
M. C. de Bruijne
- Bohn Stafleu van Loghum