Evaluation of the guideline-adherence of coronary angiography in patients with suspected chronic coronary syndrome – Results from the German prospective multicentre ENLIGHT-KHK project

Wein, Bastian; Seleznova, Yana; Müeller, Dirk; Naumann, Marie; Loeser, Simon; Artmann, Joerg; Fritz, Thomas; Steffen, Melanie; Windhoevel, Ute; Haude, Michael; Dahl, Juergen vom; Schaefer, U. W.; Montenbruck, Moritz; Zarse, Markus; Jegodka, Ruediger; Dill, Thorsten; Guelker, Jan‐Erik; Boese, Dirk; Bruder, Oliver

doi:10.1016/j.ijcha.2023.101203

Cited by 5 publications

(2 citation statements)

References 15 publications

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“…To fill this gap in evidence, to evaluate the health-economic consequences of GL non-adherent use of CA, and to detect facilitators and barriers of GL-adherent care the multi-facetted ENLIGHT-KHK project was conducted [11] . Results on GL-adherence in the use of CA in chronic coronary syndrome (CCS), on health economic consequences and on factors influencing GL-adherence were already published [12] , [13] , [14] .…”

Section: Introductionmentioning

confidence: 99%

Guideline adherence in the use of coronary angiography in patients presenting at the emergency department without myocardial infarction – Results from the German ENLIGHT-KHK project

Wein,

Seleznova,

Mueller

et al. 2023

IJC Heart & Vasculature

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Section: Introductionmentioning

confidence: 99%

Guideline adherence in the use of coronary angiography in patients presenting at the emergency department without myocardial infarction – Results from the German ENLIGHT-KHK project

Wein,

Seleznova,

Mueller

et al. 2023

IJC Heart & Vasculature

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“…Therefore, a multidisciplinary Heart Team discussion to ensure personalized decision-making and alignment between evidence and practice is clearly required [14] . Wein and colleagues reported low adherence to guidelines for patients with CAD [15] . In the last 20 years, PCI has become the treatment of choice in most cases of CAD, and several technical aspects have been demonstrated to significantly affect patient outcomes.…”

mentioning

confidence: 99%

Recent highlights on coronary artery disease from the International Journal of Cardiology Heart & Vasculature

Tedeschi,

Ammirati,

Conti

et al. 2023

IJC Heart & Vasculature

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Factors influencing adherence to clinical practice guidelines in patients with suspected chronic coronary syndrome: a qualitative interview study in the ambulatory care sector in Germany

Naumann,

Scharfenberg,

Seleznova

et al. 2023

BMC Health Serv Res

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Background Chronic coronary syndrome (CCS) is a potentially progressive clinical presentation of coronary artery disease (CAD). Clinical practice guidelines (CPGs) are available for prevention, diagnosis, and treatment. Embedded in the “ENLIGHT-KHK” healthcare project, a qualitative study was conducted to identify factors that influence guideline adherence from the perspective of general practitioners (GPs) and cardiologists (CA) in the ambulatory care sector in Germany. Methods GPs and CAs were surveyed via telephone using an interview guide. The respondents were first asked about their individual approach to caring for patients with suspected CCS. Subsequently, the accordance of their approach with guideline recommendations was addressed. Finally, potential measures for assisting with guideline adherence were discussed. The semi-structured interviews were transcribed verbatim and analysed using a qualitative content analysis in accordance with Kuckartz and Rädiker. Factors influencing adherence to CPGs were categorised by assessing whether they (i) inhibited or facilitated guideline adherence, (ii) played a role in patients at risk of CCS or with suspected or known CCS, (iii) were mentioned in implicit or explicit thematic reference to CPGs, and (iv) were declared a practical problem. Results Based on interviews with ten GPs and five CAs, 35 potential influencing factors were identified. These emerged at four levels: patients, healthcare providers, CPGs, and the healthcare system. The most commonly cited barrier to guideline adherence among the respondents was structural aspects at the system level, including reachability of providers and services, waiting times, reimbursement through statutory health insurance (SHI) providers, and contract offers. There was a strong emphasis on interdependencies between factors acting at different levels. For instance, poor reachability of providers and services at the system level may result in inexpedience of guideline recommendations at the CPG level. Likewise, poor reachability of providers and services at the system level may be aggravated or alleviated by factors such as diagnostic preferences at the patient level or collaborations at the provider level. Conclusions To assist with adherence to CPGs regarding CCS, promoting measures may be needed that account for interdependencies between barriers and facilitators at various healthcare levels. Respective measures should consider medically justified deviations from guideline recommendations in individual cases. Trial registration German Clinical Trials Register: DRKS00015638; Universal Trial Number (UTN): U1111-1227-8055.

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Evaluation of the guideline-adherence of coronary angiography in patients with suspected chronic coronary syndrome – Results from the German prospective multicentre ENLIGHT-KHK project

Cited by 5 publications

References 15 publications

Guideline adherence in the use of coronary angiography in patients presenting at the emergency department without myocardial infarction – Results from the German ENLIGHT-KHK project

Guideline adherence in the use of coronary angiography in patients presenting at the emergency department without myocardial infarction – Results from the German ENLIGHT-KHK project

Recent highlights on coronary artery disease from the International Journal of Cardiology Heart & Vasculature

Factors influencing adherence to clinical practice guidelines in patients with suspected chronic coronary syndrome: a qualitative interview study in the ambulatory care sector in Germany

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