Why the study?
Does a multifaceted quality improvement intervention improve the use of evidence-based therapies in patients with acute coronary syndromes?
Population
1,150 patients with acute coronary syndromes across 34 public hospitals in Brazil. Mean age 62, 68.6% men.
Comparison
Multifaceted quality improvement intervention… vs Routine practice (control)
Design
RCT, cluster-randomized (concealed allocation)
Follow-up
30-day
Key result
A multifaceted quality improvement intervention increased the receipt of all eligible evidence-based therapies within 24 hours compared to routine practice (67.9% vs 49.5%; OR 2.64, 95% CI 1.28-5.45).
Authors
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Supports implementing multifaceted QI interventions to boost early evidence-based ACS therapy use; extends prior evidence to middle-income settings.
RCT (n=1,150)
cluster-randomized (concealed allocation)
Yes
Does a multifaceted quality improvement intervention improve the use of evidence-based therapies in patients with acute coronary syndromes?
Odds Ratio: 2.64 (95% CI 1.28–5.45)
Absolute Event Rate: 67.9% vs 49.5%
A multifaceted quality improvement intervention significantly increased adherence to evidence-based acute therapies for patients with acute coronary syndromes in a middle-income country setting.
Berwanger et al. (2012) conducted an RCT in Acute coronary syndromes (ACS) (n=1,150). Multifaceted quality improvement intervention vs. Routine practice was evaluated on Percentage of eligible patients who received all evidence-based therapies (aspirin, clopidogrel, anticoagulants, and statins) during the first 24 hours (OR 2.64, 95% CI 1.28-5.45). A multifaceted quality improvement intervention increased the receipt of all eligible evidence-based therapies within 24 hours compared to routine practice (67.9% vs 49.5%; OR 2.64, 95% CI 1.28-5.45).
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