A tool for assessment of heart failure prescribing quality: A systematic review and meta-analysis

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dc.contributor.author El Hadidi, Seif
dc.contributor.author Darweesh, Ebtissam
dc.contributor.author Byrne, Stephen
dc.contributor.author Bermingham, Margaret
dc.date.accessioned 2018-06-06T08:59:18Z
dc.date.available 2018-06-06T08:59:18Z
dc.date.issued 2018-05-16
dc.identifier.citation Seif, E. H., Ebtissam, D., Stephen, B. and Margaret, B. 'A tool for assessment of heart failure prescribing quality: A systematic review and meta‐analysis', Pharmacoepidemiology and Drug Safety, In Press. doi: 10.1002/pds.4430 en
dc.identifier.volume 0 en
dc.identifier.issued 0 en
dc.identifier.startpage 1 en
dc.identifier.endpage 10 en
dc.identifier.issn 1053-8569
dc.identifier.issn 1099-1557
dc.identifier.uri http://hdl.handle.net/10468/6247
dc.identifier.doi 10.1002/pds.4430
dc.description.abstract Introduction: Heart failure (HF) guidelines aim to standardise patient care. Internationally, prescribing practice in HF may deviate from guidelines and so a standardised tool is required to assess prescribing quality. A systematic review and meta‐analysis were performed to identify a quantitative tool for measuring adherence to HF guidelines and its clinical implications. Methods: Eleven electronic databases were searched to include studies reporting a comprehensive tool for measuring adherence to prescribing guidelines in HF patients aged ≥18 years. Qualitative studies or studies measuring prescription rates alone were excluded. Study quality was assessed using the Good ReseArch for Comparative Effectiveness Checklist. Results: In total, 2455 studies were identified. Sixteen eligible full‐text articles were included (n = 14 354 patients, mean age 69 ± 8 y). The Guideline Adherence Index (GAI), and its modified versions, was the most frequently cited tool (n = 13). Other tools identified were the Individualised Reconciled Evidence Recommendations, the Composite Heart Failure Performance, and the Heart Failure Scale. The meta‐analysis included the GAI studies of good to high quality. The average GAI‐3 was 62%. Compared to low GAI, high GAI patients had lower mortality rate (7.6% vs 33.9%) and lower rehospitalisation rates (23.5% vs 24.5%); both P ≤ .05. High GAI was associated with reduced risk of mortality (hazard ratio = 0.29, 95% confidence interval, 0.06‐0.51) and rehospitalisation (hazard ratio = 0.64, 95% confidence interval, 0.41‐1.00). No tool was used to improve prescribing quality. Conclusion: The GAI is the most frequently used tool to assess guideline adherence in HF. High GAI is associated with improved HF outcomes. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Wiley en
dc.relation.uri https://onlinelibrary.wiley.com/doi/abs/10.1002/pds.4430
dc.rights © 2018 John Wiley & Sons Ltd. This is the pre-peer reviewed version of the following article: El Hadidi S, Darweesh E, Byrne S, Bermingham M. A tool for assessment of heart failure prescribing quality: A systematic review and meta‐analysis. Pharmacoepidemiol Drug Saf. 2018;1–10, which has been published in final form at https://doi.org/10.1002/pds.4430. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. en
dc.subject Appropriate prescribing en
dc.subject Guideline adherence en
dc.subject Guideline Adherence Index en
dc.subject Guideline‐led prescribing en
dc.subject Heart failure en
dc.title A tool for assessment of heart failure prescribing quality: A systematic review and meta-analysis en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Margaret Bermingham, School Of Pharmacy, University College Cork, Cork, Ireland. +353-21-490-3000 Email: margaret.bermingham@ucc.ie en
dc.internal.availability Full text available en
dc.date.updated 2018-06-06T08:50:16Z
dc.description.version Submitted Version en
dc.internal.rssid 440524930
dc.description.status Peer reviewed en
dc.identifier.journaltitle Pharmacoepidemiology and Drug Safety en
dc.internal.copyrightchecked No !!CORA!! en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress margaret.bermingham@ucc.ie en
dc.internal.bibliocheck In Press June 2018. Update citation, add vol, issue, update start page end page en


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