Quantify Use of Anticoagulation to Improve Management of AF
Trial Snapshot
- Phase
- Not Applicable
- Status
- Terminated
- Enrollment
- 2,000
- Locations
- 61
- Primary Endpoint
- Change in the Percentage of Patients Treated With OAC From Baseline to Final Collection Periods
Study Overview
Brief Summary
The purpose of this study is to evaluate the impact of a hospital quality improvement (QI) program on the use of guideline-recommended oral anticoagulants (OAC) in hospitalized patients with atrial fibrillation (AF) at risk for ischemic stroke. Specifically, the study will determine whether the intervention, compared to Usual Care, will result in a greater increase in the proportion of patients with AF at risk for ischemic stroke who are appropriately treated with OAC.
Study Design
- Study Type
- Observational
- Observational Model
- Cohort
- Time Perspective
- Prospective
Eligibility Criteria
- Ages
- 40 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Inpatient hospitalization
- •Primary or secondary discharge International Classification of Diseases (ICD)-9/10 diagnosis code for AF paroxysmal (I48.0), persistent (I48.1), chronic (I48.2), or unspecified (427.31, I48.91)
- •Proxied Congestive Heart failure (CHA2DS2-VASC) score greater than or equal to (>=) 2 using ICD-9 diagnosis scoring algorithm developed previously. The scoring algorithm will be expanded to include ICD-10 codes
- •Discharged to home, skilled nursing facility, inpatient rehabilitation, or nursing home
Exclusion Criteria
- •Presence of artificial mechanical heart valve by ICD-9/10 diagnosis or procedure code during comorbid identification period or current hospitalization
- •Surgical procedure during hospitalization for open heart surgery, brain, or spine
- •Intravenous heparin given on the day of discharge without warfarin/oral anticoagulant (OAC), antiplatelets, and/or aspirin
- •History of left atrial appendage occlusion, including the Watchman device
- •Any in-hospital (current hospitalization) bleeding identified by ICD-9/10 diagnosis codes
Outcomes
Primary Outcomes
Change in the Percentage of Patients Treated With OAC From Baseline to Final Collection Periods
Time Frame: Baseline up to 20 months
The impact of a hospital quality improvement (QI) program on the use of guideline-recommended oral anticoagulants (OAC) in hospitalized patients with atrial fibrillation (AF) at risk for ischemic stroke will be evaluated by measuring change in the percentage of patients treated with OAC, from baseline to Final Collection Periods.
Secondary Outcomes
- Effect of Degree of Engagement in the QI Program(End of study (Month 20))
- Percentage of Patients Readmitted to the Same Hospital(Up to 20 months)
- Percentage of Patients who Received OAC by Hospital Characteristics Subgroups(End of study (Month 20))
- Effect of Tools Components of the QI Program on the use of OAC(End of study (Month 20))