Quality Measurement and Improvement Study of Surgical Coronary Revascularization: Secondary Prevention
- Conditions
- Coronary Artery Bypass GraftingSecondary Preventions
- Interventions
- Behavioral: Quality improvement strategies
- Registration Number
- NCT02430012
- Lead Sponsor
- China National Center for Cardiovascular Diseases
- Brief Summary
The investigators have identified underuse of secondary prevention medications at discharge of patients underwent coronary artery bypass grafting (CABG) in China. The aim of this study is to develop series of quality improvement strategies focusing on secondary prevention medications for patients underwent CABG, and to evaluate their effectiveness and safety via a hospital-level cluster randomized clinical trial. The investigators established a network of 60 hospitals which have participated into Chinese Cardiovascular Surgery Registry and submitted 50 or more CABG surgeries already. The participating sites will be divided into intervention and control groups in a 1:1 ratio. The intervention group will undertake intervention of quality improvement strategies, while the control group will maintain the routine practice pattern. All hospitals will consecutively enroll and submit data of CABG during the enrollment period, estimated for 6 months. The prescribing rates of angiotensin converting enzyme inhibitor (ACEI), angiotensin receptor blocker (ARB), beta-blockers, statins and aspirins will be compared between 2 groups.
- Detailed Description
The investigators have identified underuse of secondary prevention medications at discharge of patients underwent coronary artery bypass grafting (CABG) in China. The aim of this study is to develop series of quality improvement strategies focusing on secondary prevention medications for patients underwent CABG, and to evaluate their effectiveness and safety via a hospital-level cluster randomized clinical trial. The investigators established a network of 60 hospitals which have participated into Chinese Cardiovascular Surgery Registry and submitted 50 or more CABG surgeries already. The participating sites will be divided into intervention and control groups in a 1:1 ratio. The intervention group will undertake intervention of quality improvement strategies, while the control group will maintain the routine practice pattern. All hospitals will consecutively enroll and submit data of CABG during the enrollment period of estimated 6 months. The prescription rates of ACEI, ARB, beta-blockers, statins and aspirins will be compared between 2 groups.
Before the enrollment period, the investigators have developed series of quality improvement strategies focusing on secondary prevention medications for patients underwent CABG, including training with guidelines of secondary preventions, determining improvement goals with participating sites, intervention tools (workflow posters and cards, checklists to inform the use of secondary prevention medications) and periodical quality feedback reports.
In the enrollment period, participating hospitals will be divided into intervention and control groups in a 1:1 ratio using minimization allocation.
The investigators will collect data on the prescription rates from central medical record abstraction, case report forms submitted by participating sites and checklists submitted by intervention groups.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 10009
- Patients underwent CABG during the enrollment period in participating sites
- Patients who die during hospitalization
- Patients who withdrawn from hospital against doctors' recommendations
- Patients who transfer out to other medical care institutions without discharge prescription
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Intervention group Quality improvement strategies The intervention group will take the secondary prevention quality improvement strategies into implementation.
- Primary Outcome Measures
Name Time Method statins use at discharge 14 days on average (during hospitalization) Proportion of statins prescription at discharge among eligible patients
- Secondary Outcome Measures
Name Time Method ACEI/ARBs use at discharge 14 days on average (during hospitalization) Proportion of β-blockers prescription at discharge among eligible patients
β-blockers use at discharge 14 days on average (during hospitalization) Proportion of β-blockers prescription at discharge among eligible patients
aspirins use at discharge 14 days on average (during hospitalization) Proportion of aspirins prescription at discharge among eligible patients
Trial Locations
- Locations (1)
China National Center for Cardiovascular Diseases
🇨🇳Beijing, Beijing, China