• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • 2MM Podcast
  • Write for us
  • Contact Us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Cardiology

Quality improvement interventions increase adherence to performance measures for stroke in China

byDaniel Fisher
July 5, 2018
in Cardiology, Chronic Disease, Emergency, Imaging and Intervention, Neurology, Public Health
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. In this cluster-randomized clinical trial, quality improvement interventions led to slightly greater adherence of evidence-based, performance measures compared to care as usual for acute ischemic stroke management in China.

2. Quality improvement interventions were associated with fewer vascular events and less stroke disability over one year of follow up.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Evidence-based guidelines for acute ischemic stroke management, such as timely tPA treatment and antiplatelet therapy for atrial fibrillation patients, have been shown to improve outcomes for patients. However, adherence to these performance measures is suboptimal in some developing countries, such as China. In this cluster-randomized clinical trial, multifaceted quality improvement interventions to increase adherence to nine performance measures were enforced in multiple public hospitals in China and compared to care as usual for patients with acute ischemic stroke. As a composite, the intervention group had better adherence to the performance measures but did not have better “all-or-nothing” adherence, defined as complete adherence to all nine performance measures. In particular, adherence to two out of the nine measures were statistically increased in the intervention group: DVT prophylaxis and antidiabetic medication. In addition, quality improvement interventions were associated with fewer vascular events and less stroke disability over one year of follow up.

Though this study suggests that quality improvement interventions are likely to lead to greater adherence to performance measures for stroke and better overall clinical outcomes, it should be noted that this study resulted in a smaller change in adherence than predicted by its power analysis. In addition, it is not clear if the results in this study will be generalizable to other developing countries. Still, this study adds to a growing body of literature suggesting that quality improvement initiatives can make significant changes in patient outcomes.

Click here to read the study, published in JAMA

RELATED REPORTS

Impaired lipoprotein cholesterol ratio is associated with cognitive impairment in patients with stroke

Delayed alteplase has clinical benefits in posterior circulation stroke outcomes

Direct oral anticoagulants increase bleeding risk after intracerebral hemorrhage in patients with atrial fibrillation

In-Depth [randomized controlled trial]: In the Intervention to Bridge the Evidence-based Gap in Stroke Care Quality (GOLDEN BRIDGE-AIS) Trial, 40 hospitals from 18 Chinese provinces recruited 2400 acute ischemic stroke patients per group (intervention vs care as usual) in a clustered randomized manner and followed them for 3, 6, and 12 months (83.5% and 82.4% follow rates for the intervention and control groups, respectively). The quality care intervention consisted of evidence-based clinical pathways, written care protocols for implementation of performance measures, a full-time quality coordinator, and a monitoring and feedback system. The nine performance measures that have been shown to improve outcomes for stroke patients were formulated from evidence-based recommendations created by a panel of stroke experts and according to peer-reviewed literature.

For the composite measure of adherence, defined as the total number of performance measures performed divided by the total number of total performance measures, the intervention group had a slight but significant increase in adherence (88.2% intervention group vs 84.8% control group; absolute difference 3.54%; CI95 0.68 to 6.40%). For “all-or-nothing” adherence, defined as the proportion of patients who received all of the performance measures, there was no significant difference between groups (absolute difference 6.69%; CI95 -0.41 to 13.79%). In particular, adherence to two out of the nine measures were statistically increased in the intervention group: DVT prophylaxis and antidiabetic medication (p < 0.05). New clinical vascular events were reduced in the intervention group at 3 months (hazard ratio 0.65; CI95 0.49 to 0.86), 6 months (HR 0.72; CI95 0.57 to 0.90), and 12 months (HR 0.72; CI95 0.60 to 0.87). Stroke-related disability was reduced in the intervention group at 3 months (odds ratio 0.76; CI95 0.63 to 0.91), 6 months (OR 0.74; CI95 0.61 to 0.89), and 12 months (OR 0.74; CI95 0.59 to 0.93).

Image: CC/Wiki

©2018 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: ischemic strokequality improvement
Previous Post

Regular marijuana use is associated with development of respiratory issues

Next Post

Placement of implantable cardioverter-defibrillators significantly decreases following Department of Justice investigation

RelatedReports

Quick Take: Functional Outcome of Intravenous Thrombolysis in Patients With Lacunar Infarcts in the WAKE-UP Trial
Chronic Disease

Impaired lipoprotein cholesterol ratio is associated with cognitive impairment in patients with stroke

June 4, 2025
Stroke expansion following intra-arterial therapy may explain worse outcomes
Emergency

Delayed alteplase has clinical benefits in posterior circulation stroke outcomes

May 30, 2025
Use of aspirin for primary prevention linked to increased risk of intracranial hemorrhage
Cardiology

Direct oral anticoagulants increase bleeding risk after intracerebral hemorrhage in patients with atrial fibrillation

May 2, 2025
Non-alcoholic fatty liver disease and risk of incident acute myocardial infarction and stroke: findings from matched cohort study of 18 million European adults
Emergency

Tenecteplase and alteplase demonstrate similar efficacy for acute ischemic stroke

March 22, 2025
Next Post
No survival benefit with ICDs in non-ischemic systolic heart failure: The DANISH trial

Placement of implantable cardioverter-defibrillators significantly decreases following Department of Justice investigation

2 Minute Medicine Rewind July 9, 2018

Decreased prevalence of HPV among vaccinated young females

Primary HPV testing may detect cervical neoplasms earlier and more accurately than cytology

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Structured Exercise after Adjuvant Chemotherapy for Colon Cancer
  • 2 Minute Medicine Rewind June 30, 2025
  • Weighted vests and resistance training confer similar outcomes for bone density in the elderly
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
No Result
View All Result

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.