Abstract 3280: Heart Failure Quality of Care in the Outpatient Cardiology Practice Setting: A Report from IMPROVE HF

Abstract

Introduction: Few data exist regarding adherence to evidence-based HF guidelines in the outpatient setting. IMPROVE HF is a prospective cohort study designed to characterize the current management of chronic systolic HF (EF<35%) in a national registry of outpatient cardiology practices and to evaluate the effect of practice-specific performance improvement interventions. Methods: Baseline performance data were collected by chart abstraction. To quantify care, IMPROVE HF performance measures were constructed for use of: ACEI/ARB, beta-blocker, aldosterone antagonist, anticoagulation for atrial fibrillation, ICD, CRT and HF education. Conformity with guideline indicated care includes only patients documented to be eligible without contraindications or intolerance. Results: 131 practices are enrolled with baseline data abstracted for 12331 patients. 71.7% of practices are non-teaching. Patients are 71% male, with a median age of 70.5 years and a median EF of 25%. Baseline conformity with indicated HF therapies is shown in Fig 1 . While ACEI/ARB and beta-blocker use were relatively high in eligible patients in the outpatient cardiology setting, other measures showed large treatment gaps. Conclusions: These data are among the first to assess conformity to the latest national HF guidelines in the outpatient setting and demonstrate an opportunity to improve the quality of HF care delivered. IMPROVE HF will explore the impact of practice-specific performance improvement tools on closing the outpatient HF treatment gap.