Quality of care assessment and improvement in aortic stenosis - rationale and design of a multicentre registry (IMPULSE)

BMC Cardiovascular Disorders

Study Protocol

Eberhard Schulz¹  Stephan Baldus²  Matthias Lutz³  Norbert Frey³  David Messika-Zeitoun⁴  Jana Kurucova⁵  Antonio Serra⁶  Peter Bramlage⁷  Christiane Pohlmann⁷  Richard P. Steeds⁸ 

[1] Cardiology Department I, University Clinic Mainz, Mainz, Germany;Clinic for Cardiology, Angiology, and Pneumology and Intensive Care Medicine, Heart Center of the University Clinic Cologne, Cologne, Germany;Department of Cardiology and Angiology, University of Kiel, Kiel, Germany;Department of Cardiology, Bichat Hospital, Paris, France;Edwards Lifesciences, Prague, Czech Republic;Hospital de Sant Pau, Cardiology Unit, University of Barcelona, Barcelona, Spain;Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany;Queen Elizabeth Hospital and Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK;

关键词: Quality of care;    Aortic stenosis;    Transcatheter aortic valve implantation;    Surgical aortic valve replacement;    Facilitated data relay;   

DOI  :  10.1186/s12872-016-0439-4

 received in 2016-07-05, accepted in 2016-12-08,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundSevere aortic stenosis (AS) is a common, serious valve disease in which no effective medical therapy is available and, if not treated by intervention, has a 5-year survival of only 40–60%. Despite the availability of guidelines supporting the effective use of surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI) to treat the majority of these patients, adherence to these guidelines in clinical practice is still unsatisfactory. Several recent studies have emphasised the necessity for improved communication between multidisciplinary teams, with the aim to ensure that severe AS patients receive appropriate treatment.Methods/designIMPULSE is a prospective, multicentre, European registry designed to gather data over 12 months on the treatment decisions made by referring physicians for patients newly diagnosed with severe AS. Each patient has a follow-up of 3 months. The study will consist of two observational phases to assess the appropriateness and rate of referral based on current guidelines prior to and after an interventional phase aiming to determine whether a simple quality of care intervention improves patient management.DiscussionData will be analysed firstly, to determine the appropriateness of treatment decisions for the management of severe AS in current European clinical practice, and secondly, to evaluate the effectiveness of facilitated data relay from a designated echocardiography department nurse to the referring physician early after diagnosis in improving quality of care. Additionally, variables will be identified that are associated with inappropriate decision-making. Collectively, the aim will be to design a clinical pathway that will improve the timely management of patients with newly diagnosed severe AS.

【 授权许可】

CC BY   
© The Author(s). 2017