Evidence map›Paper›PMID 24940068›Full record

ArticleVascular health and risk management2014

Vascular quality of care pilot study: how admission to a vascular surgery service affects evidence-based pharmacologic risk factor modification in patients with lower extremity peripheral arterial disease.

Naomi Steenhof, Francesca Le Piane, Kori Leblanc, Naomi R Eisenberg, Yvonne Kwan, Christine Malmberg, Alexandra Papadopoulos, Graham Roche-Nagle

Open access · goldAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Vascular health and risk management, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.2field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. PAD in women: the ischemic continuum.Current atherosclerosis reports · 2015
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

Naomi SteenhofDepartment of Pharmacy, University Health Network, Toronto, ON, Canada ; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
Francesca Le PianeDepartment of Pharmacy, University Health Network, Toronto, ON, Canada.
Kori LeblancDepartment of Pharmacy, University Health Network, Toronto, ON, Canada ; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada ; Centre for Innovation in Complex Care, University Health Network, Toronto, ON, Canada.
Naomi R EisenbergDivision of Vascular Surgery, University Health Network, Toronto, ON, Canada.
Yvonne KwanDepartment of Pharmacy, University Health Network, Toronto, ON, Canada.
Christine MalmbergDepartment of Pharmacy, University Health Network, Toronto, ON, Canada ; Victoria General Hospital, Vancouver Island Health Authority, Victoria, BC, Canada.
Alexandra PapadopoulosFaculty of Nursing, University of Toronto, Toronto, ON, Canada ; Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada.
Graham Roche-NagleDivision of Vascular Surgery, University Health Network, Toronto, ON, Canada ; Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada ; Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
University Health Network · CAIsland Health · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeripheral arterial disease (PAD) guidelines recommend aggressive risk factor modification to improve cardiovascular outcomes. Recommended pharmacologic therapies include antiplatelets, angiotensin converting enzyme (ACE) inhibitors, and HMG-CoA-reductase inhibitors (statins). PURPOSE: We studied the degree to which patient admission to a vascular surgery service increased the use of these therapies. PATIENTS AND

methodsThe authors conducted a retrospective chart review of 150 patients with PAD admitted to the vascular surgery service at a large Canadian tertiary care hospital. The use of recommended pharmacologic therapies at the time of admission and discharge were compared. A multidisciplinary clinical team established criteria by which patients were deemed ineligible to receive any of the recommended therapies. Angiotensin receptor blockers (ARBs) were considered an alternative to ACE inhibitors.

resultsPrior to hospital admission, 64% of patients were on antiplatelet therapy, 67% were on an ACE inhibitor or ARB, and 71% were on a statin. At the time of discharge, 91% of patients were on an antiplatelet (or not, with an acceptable reason), 77% were on an ACE inhibitor or an ARB (or not, with an acceptable reason), and 85% were on a statin (or not, with an acceptable reason). While new prescriptions were largely responsible for improved guideline adherence with antiplatelets and statins, most of the apparent improvement in ACE inhibitor and ARB use was the result of identifying an acceptable reason for not having them prescribed.

conclusionThis hypothesis generating pilot study supports the findings of others that there is suboptimal prescription of pharmacologic risk reduction therapies in the PAD population. Admission to a vascular service increases these rates. Nevertheless, some patients are still not receiving evidence-based treatment at discharge even after consideration of acceptable reasons. Strategies are needed to improve PAD guideline adherence in both the community at large and the vascular surgery service.

Indexed as

Patient AdmissionPractice Patterns, Physicians'Quality of Health CareVascular Surgical ProceduresAdultAgedAged, 80 and overCardiovascular AgentsDrug PrescriptionsDrug Utilization ReviewFemaleGuideline AdherenceHumansLower ExtremityMaleMiddle AgedCardiovascular Agentsguideline adherencerisk reductionvascular protection

Identifiers

PMID24940068
PMCPMC4051795
OpenAlexW2057146024

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.