Arq. Bras. Cardiol. 2023; 120(10): e20230375

A Nationwide Initiative to Improve Cardiology Quality: The Best Practice in Cardiology Program in Brazil

Fabio Papa Taniguchi , Sabrina Bernardez-Pereira , Antônio Luiz Pinho Ribeiro , Louise Morgan, Anne B. Curtis, Kathryn Taubert, Denilson Campos de Albuquerque , Sidney C Smith Jr, Angêlo Amato Vincenzo de Paola

DOI: 10.36660/abc.20230375

This Original Article is referred by the Short Editorial "A National Quality Improvement Initiative in Cardiology: The Good Practices in Cardiology Program in Brazil".

Abstract

Background

Despite significant progress in improving the quality of cardiovascular care, persistent gaps remain in terms of inconsistent adherence to guideline recommendations.

Objective

This study evaluates the effects of implementing a quality improvement program adapted from the American Heart Association’s Get with the Guidelines™ initiative on adherence to guideline-directed medical therapy for acute coronary syndrome (ACS), atrial fibrillation (AF), and heart failure (HF).

Methods

We examined demographics, quality measures, and short-term outcomes in patients hospitalized with ACS, AF, and HF enrolled in the Best Practice in Cardiology (BPC) Program from 2016 to 2022.

Results

This study included 12,167 patients in 19 hospitals in Brazil. Mean age was 62.5 [53.8-71] y/o; 61.1% were male, 68.7% had hypertension, 32.0% diabetes mellitus, and 24.1% had dyslipidemia. Composite score had a sustainable performance in the period from baseline to the last quarter: 65.8±36.2% to 73± 31.2% for AF (p=0.024), 81.0± 23.6% to 89.9 ± 19.3% for HF (p<0.001), and from 88.0 ± 19.1 to 91.2 ±14.9 for ACS (p<0.001).

Conclusions

The BPC program is a quality improvement program in Brazil in which real-time data, obtained using cardiology guideline metrics, were implemented in a quality improvement program resulting in an overall sustained improvement in AF, HF, and ACS management.