Facilitated Data Relay and Effects on Treatment of Severe Aortic Stenosis in Europe
Why the study?
Many patients with severe aortic stenosis are referred late with advanced symptoms or inappropriately denied intervention, raising the question of whether structured communication to referring physicians could improve the rate and timeliness of intervention.
Does facilitated data relay improve the rate and timeliness of intervention in patients with severe aortic stenosis?
Comparison
Facilitated data relay vs status quo documentation vs legacy effect documentation
Design
Multicenter prospective registry
Follow-up
3 months
Authors
Discussion
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Member takes
Implication
structured communication/data relay may improve TAVR/AVR timeliness in severe AS) + research.
Key Points
- To investigate whether structured communication to referring physicians (facilitated data relay) improves the rate and timeliness of intervention in severe aortic stenosis.
- Conducted a prospective multicenter trial across 23 centers in 9 European countries evaluating consecutive patients with severe aortic stenosis (N=2,171; NCT02241447).
- Structured patient flow across three consecutive intervals: a 3-month baseline assessment (Phase A, n=759), a 6-month facilitated data relay intervention phase (n=905), and a 3-month legacy phase (Phase B, n=507).
- Facilitated data relay increased the proportion of aortic valve replacements performed within 3 months from 51% at baseline to 59% during the intervention phase (P=0.002).
- Time to intervention decreased significantly from 36±38 days at baseline to 30±33 days during the intervention phase (P=0.002), driven primarily by improvements in transcatheter aortic valve replacement rather than surgical replacement.
Structured PICO
Does facilitated data relay improve the rate and timeliness of intervention in patients with severe aortic stenosis?
P
Population
2,171 consecutive patients with severe aortic stenosis at 23 centers in 9 European countries, mean age 77.9 years, 80% symptomatic (52% severe symptoms).
I
Intervention
Facilitated data relay (structured communication to referring physicians) implemented over a 6-month phase.
C
Comparator
Status quo (3-month documentation phase prior to intervention).
O
Outcome
Rate and timeliness of intervention (aortic valve replacement performed within 3 months and time to intervention).
A structured communication strategy to referring physicians significantly improves the timeliness of transcatheter aortic valve replacement for patients with severe aortic stenosis.
Cite This Study
Steeds et al. (2019) studied this question.