ACCF/AHA/ACR/SCAI/SIR/SVM/SVN/SVS 2010 Performance Measures for Adults With Peripheral Artery Disease

Olin, Jeffrey W.; Allie, David E.; Belkin, Michael; Bonow, Robert O.; Casey, Donald E.; Creager, Mark A.; Gerber, Thomas C.; Hirsch, Alan T.; Jaff, Michael R.; Kaufman, John A.; Lewis, Curtis A.; Martin, Edward T.; Martin, Louis G.; Sheehan, Peter; Stewart, Kerry J.; Treat‐Jacobson, Diane; White, Christopher J.; Zheng, Zhi

doi:10.1016/j.jacc.2010.08.606

Cited by 54 publications

(8 citation statements)

References 70 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…First, the selection of diabetes mellitus quality metrics to be assessed in DCR could be debated. The Steering Committee of DCR selected the measures from those approved by the American College of Cardiology/American Heart Association Task Force on Performance Measures19, 20, 21 and based on the existing Centers for Medicare and Medicaid Services Physician Quality Reporting System 22. Second, other quality metrics are intended to be measured in DCR (eg, counseling on diet and exercise, high‐intensity statin use in patients with coronary or peripheral artery disease) but could not be assessed because of current data limitations.…”

Section: Discussionmentioning

confidence: 99%

“…Diabetes mellitus quality metrics that were selected to be tracked in DCR (Table 1) include 7 metrics established by the American College of Cardiology/American Heart Association Task Force on Performance Measures19, 20, 21 and the Centers for Medicare and Medicaid Services Physician Quality Reporting System22: glycemic control (hemoglobin A1c checked in past year and documented to be ≤9%), blood pressure control (hypertension and blood pressure <140/90 or on ≥2 antihypertensive medications), angiotensin‐converting enzyme inhibitor (ACE‐I) or angiotensin II receptor blocker (ARB) for patients with coronary artery disease, nephropathy screening, diabetes mellitus eye examination, diabetes mellitus foot examination, and tobacco screening and cessation counseling (screened for tobacco and, if a current user, given cessation counseling). For each of the metrics, DCR worked with the individual practice and EHR provider to determine the best mechanisms to map the EHR data to determine whether the metrics are being met, which included a combination of discrete data fields, billing data, and physician notes.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Quality of Care of the Initial Patient Cohort of the Diabetes Collaborative Registry ^®

Arnold

Goyal

Inzucchi

et al. 2017

JAHA

View full text Add to dashboard Cite

BackgroundAlthough guidelines and performance measures exist for patients with diabetes mellitus, achievement of these metrics is not well known. The Diabetes Collaborative Registry® (DCR) was formed to understand the quality of diabetes mellitus care across the primary and specialty care continuum in the United States.Methods and ResultsWe assessed the frequency of achievement of 7 diabetes mellitus–related quality metrics and variability across the Diabetes Collaborative Registry® sites. Among 574 972 patients with diabetes mellitus from 259 US practices, median (interquartile range) achievement of the quality metrics across the practices was the following: (1) glycemic control: 19% (5–47); (2) blood pressure control: 80% (67–88); (3) angiotensin‐converting enzyme inhibitors/angiotensin II receptor blockers in patients with coronary artery disease: 62% (51–69); (4) nephropathy screening: 62% (53–71); (5) eye examination: 0.7% (0.0–79); (6) foot examination: 0.0% (0.0–2.3); and (7) tobacco screening/cessation counseling: 86% (80–94). In hierarchical, modified Poisson regression models, there was substantial variability in meeting these metrics across sites, particularly with documentation of glycemic control and eye and foot examinations. There was also notable variation across specialties, with endocrinology practices performing better on glycemic control and diabetes mellitus foot examinations and cardiology practices succeeding more in blood pressure control and use of angiotensin‐converting enzyme inhibitors/angiotensin II receptor blockers.ConclusionsThe Diabetes Collaborative Registry® was established to document and improve the quality of outpatient diabetes mellitus care. While target achievement of some metrics of cardiovascular risk modification was high, achievement of others was suboptimal and highly variable. This may be attributable to fragmentation of care, lack of ownership among various specialists concerning certain domains of care, incomplete documentation, true gaps in care, or a combination of these factors.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Quality of Care of the Initial Patient Cohort of the Diabetes Collaborative Registry ^®

Arnold

Goyal

Inzucchi

et al. 2017

JAHA

View full text Add to dashboard Cite

show abstract

“…25–27 The primary study outcome was treatment with 2 secondary prevention medication therapies: antiplatelet therapy (aspirin or clopidogrel) and statins, which are both Class I indications for PAD by the ACC/AHA PAD guidelines and PAD performance measures. 28,29 Patients with documented contraindications to antiplatelet therapy (e.g., history of gastrointestinal bleeding) or statins were excluded within the analysis for each treatment. Moreover, for the analyses with antiplatelet therapy, we further excluded 9,295 patients already on warfarin therapy given that warfarin may influence use of antiplatelet therapy.…”

Section: Methodsmentioning

confidence: 99%

Socioeconomic Disparities in the Use of Cardioprotective Medications Among Patients With Peripheral Artery Disease

Subherwal

Patel

Tang

et al. 2013

Journal of the American College of Cardiology

View full text Add to dashboard Cite

Objective Examine disparities in use of cardioprotective medications in treatment of peripheral artery disease (PAD) by socioeconomic status (SES). Background PAD is associated with increased cardiovascular risk and is more prevalent among those of lower SES. However, the use of guideline-recommended secondary preventive measures for the treatment of PAD across diverse income subgroups and the influence of practice site on potential treatment disparities by SES are unknown. Methods Within the National Cardiovascular Disease Registry (NCDR®) PINNACLE Registry®, 62,690 patients with PAD were categorized into quintiles of SES, as defined by the median income of each patient’s zip code. The association between SES and secondary prevention treatment with antiplatelet and statin medications was evaluated using sequential hierarchical modified Poison models, adjusting first for practice site and then for clinical variables. Results Compared with the highest SES quintile (median income >$60,868), PAD patients in the lowest SES quintile (median income <$34,486) were treated less often with statins (72.5 % vs. 85.8%; RR 0.84 [0.83–0.86]; P<0.001) and antiplatelet therapy (79.0% vs. 84.6 %; RR 0.93 [95% CI: 0.91–0.94]; P<0.001). These differences were markedly attenuated after controlling for practice site variation: statins (adjusted RR: 0.97 [0.95–0.99]; P=0.003) and antiplatelet therapy (adjusted RR 0.98 [0.97–1.00]; P=0.012). Additional adjustment for patients’ clinical characteristics had minimal impact with slight further attenuation: statins (adjusted RR: 1.00 [0.99–1.01]; p=0.772) and antiplatelet therapy (adjusted RR: 1.00 [0.99–1.01]; p=0.878). Conclusion Among PAD patients, the practice site at which patients received care largely explained the observed SES differences in treatment with guidelines-recommended secondary prevention medications. Future efforts to reduce treatment disparities in these vulnerable populations should target systems improvement at practices serving high proportions of patients with low SES.

show abstract

“…With a history of leadership in total patient care, 28 patient advocacy for disease preventions, 29,30 and advanced organizational initiatives in quality measurement improvement, 31 vascular surgeons and the SVS stand in an advantageous position to establish and validate quality measures in vascular care. For example, the Society for Vascular Surgery (SVS) has been active in producing guidelines for carotid disease, 32 peripheral arterial disease, 33 venous disease, 34 and AAA/TAA, 35,36 both within the SVS and in broader forums such as the American Heart Association (Table IV). …”

Section: Why Quality Measures Will Mattermentioning

confidence: 99%

Roles for specialty societies and vascular surgeons in accountable care organizations

Goodney

Cambria

2012

Journal of Vascular Surgery

View full text Add to dashboard Cite

With the passage of the Affordable Care Act, accountable care organizations (ACOs) represent a new paradigm in healthcare payment reform. Designed to limit growth in spending while preserving quality, these organizations aim to incant physicians to lower costs by returning a portion of the savings realized by cost-effective, evidence-based care back to the ACO. In this review, first, we will explore the development of ACOs within the context of prior attempts to control Medicare spending, such as the sustainable growth rate and managed care organizations. Second, we describe the evolution of ACOs, the demonstration projects that established their feasibility, and their current organizational structure. Third, because quality metrics are central to the use and implementation of ACOs, we describe current efforts to design, collect, and interpret quality metrics in vascular surgery. And fourth, because a “seat at the table” will be an important key to success for vascular surgeons in these efforts, we discuss how vascular surgeons can participate and lead efforts within ACOs.

show abstract

ACCF/AHA/ACR/SCAI/SIR/SVM/SVN/SVS 2010 Performance Measures for Adults With Peripheral Artery Disease

Cited by 54 publications

References 70 publications

Quality of Care of the Initial Patient Cohort of the Diabetes Collaborative Registry ^®

Quality of Care of the Initial Patient Cohort of the Diabetes Collaborative Registry ^®

Socioeconomic Disparities in the Use of Cardioprotective Medications Among Patients With Peripheral Artery Disease

Roles for specialty societies and vascular surgeons in accountable care organizations

Contact Info

Product

Resources

About

ACCF/AHA/ACR/SCAI/SIR/SVM/SVN/SVS 2010 Performance Measures for Adults With Peripheral Artery Disease

Cited by 54 publications

References 70 publications

Quality of Care of the Initial Patient Cohort of the Diabetes Collaborative Registry ®

Quality of Care of the Initial Patient Cohort of the Diabetes Collaborative Registry ®

Socioeconomic Disparities in the Use of Cardioprotective Medications Among Patients With Peripheral Artery Disease

Roles for specialty societies and vascular surgeons in accountable care organizations

Contact Info

Product

Resources

About

Quality of Care of the Initial Patient Cohort of the Diabetes Collaborative Registry ^®

Quality of Care of the Initial Patient Cohort of the Diabetes Collaborative Registry ^®