ArticleBMC health services research2018
A physician targeted intervention improves prescribing in chronic heart failure in general medical units.
Article in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.
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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.
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.
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Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 9 citations in OpenAlex.
- Understanding how and why audits work in improving the quality of hospital care: A systematic realist review.PloS one · 2021Pooled it
- Use of interrupted time series methods in the evaluation of health system quality improvement interventions: a methodological systematic review.BMJ global health · 2020Pooled it
- Bridging the gap in heart failure management: the effect of a cross-disciplinary intervention on guidelines-directed medical therapy in primary care.ESC heart failure · 2026Article
- Suboptimal heart rate control despite beta-blocker use in coronary artery disease: evidence from the Fasa PERSIAN cohort.BMC cardiovascular disorders · 2025Article
- Clinical Heart fAilure Management Program: Changing the practice by partnering primary care and specialists (CHAMP-HF).International journal of cardiology. Heart & vasculature · 2024Article
- Effects of Holding Beta-Blockers on the Vital Signs of Heart Failure Patients.Cardiology research · 2021Article
- Optimisation of diagnosis and treatment of heart failure in a primary care setting.BMJ open quality · 2019Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite strong evidence for beta-blockers and angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) in chronic heart failure (CHF), they have been under-utilised especially in general medical units. We aim to evaluate the effectiveness and feasibility of a physician-targeted quality improvement intervention with education and feedback on the prescription of beta-blockers and ACEI/ARB for CHF management in an inpatient setting.
methodsWe conducted an interrupted time series study between January 2009 and February 2012. A two-stage intervention was implemented. Between November 2009 and January 2011, a structured physician-oriented education program was undertaken. From February 2011, quarterly performance feedback was provided to each medical unit by a senior clinician. Medical notes of patients admitted with CHF under general medical units before and during the intervention were prospectively audited. Main outcomes were beta-blockers and ACEI/ARB prescription rates, and 180-day readmission rates for CHF.
resultsFour hundred and sixty-eight patients were included in this study. Structured education program was associated with a significant rise in beta-blockers prescription rates from a baseline of 60 to 92% (p = 0.003), but a non-sustained rise in ACEI/ARB prescription. Regular performance feedback resulted in a further sustained increase in ACEI/ARB prescription rates from 62 to 93% (p = 0.028) and a positive trend for beta-blockers with rates maintained at 89%. There was a reduction in 180-day readmission rates that correlated with the improvements in beta-blocker (p = 0.030) and ACEI/ARB (p = 0.035) prescription.
conclusionImplementation of a structured education program with regular performance feedback was durable and was associated with improvements in appropriate prescribing and an observed decrease in CHF-related readmissions.
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Registered trials
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