Rationale and design for a cluster randomized quality-improvement trial to increase the uptake of evidence-based therapies for patients at high cardiovascular risk: The BRIDGE-CARDIOVASCULAR PREVENTION trial

Publication date: Available online 17 October 2018Source: American Heart JournalAuthor(s): Maria Julia Machline-Carrion, Rafael Marques Soares, Lucas Petri Damiani, Viviane Bezerra Campos, Bruna Sampaio, Juliana Yamashita, Francisco H. Fonseca, Maria Cristina Izar, Celso Amodeo, Octavio Marques Pontes-Neto, Pedro Gabriel de Melo Barros, Renato D. Lopes, Nilton Brandão da Silva, Hélio Penna Guimarães, Leopoldo Piegas, Airton T. Stein, Otavio BerwangerAbstractBackgroundTranslating evidence into clinical practice in the management of high cardiovascular risk patients is challenging. Few quality improvement interventions have rigorously evaluated their impact on both patient care and clinical outcomes.ObjectivesThe main objectives are to evaluate the impact of a multifaceted educational intervention on adherence to local guidelines for the prescription of statins, antiplatelets and angiotensin converting enzyme inhibitors or angiotensin II receptor blockers for high cardiovascular risk patients, as well as on the incidence of major cardiovascular events.DesignWe designed a pragmatic two arm cluster randomized trial involving 40 clusters. Clusters are randomized to receive a multifaceted quality improvement intervention or to routine practice (control). The multifaceted intervention includes: reminders, care algorithms, training of a case manager, audit and feedback reports, and distribution of educational materials to health care providers. The primary endpoint is the adherenc...
Source: American Heart Journal - Category: Cardiology Source Type: research