Health Status Variation Across Practices in Outpatients With Heart Failure: Insights From the CHAMP-HF (Change the Management of Patients With Heart Failure) Registry

Overview

Journal Circ Cardiovasc Qual Outcomes

Specialty Cardiology & Vascular Diseases

Date 2018 Apr 9

PMID 29627798

Citations 12

Authors

Yevgeniy Khariton

Adrian F Hernandez

Gregg C Fonarow

Puza P Sharma

Carol I Duffy

Laine Thomas

Xiaojuan Mi

Nancy M Albert

Javed Butler

Kevin McCague

Michael E Nassif

Fredonia B Williams

Adam Devore

J Herbert Patterson

John A Spertus

Affiliations

Soon will be listed here.

Abstract

Background: Although a key treatment goal for patients with heart failure with reduced ejection fraction is to optimize their health status (their symptoms, function, and quality of life), the variability across outpatient practices in achieving this goal is unknown.

Methods And Results: In the CHAMP-HF (Change the Management of Patients With Heart Failure) registry, associations between baseline practice characteristics and Kansas City Cardiomyopathy Questionnaire (KCCQ) Overall Summary (OS) and Symptom Frequency (SF) scores were assessed in 3494 patients across 140 US practices using hierarchical regression after accounting for 23 patient and 11 treatment characteristics. We then calculated an adjusted median odds ratio to quantify the average difference in likelihood that a patient would have excellent (KCCQ-OS, ≥75) health status or minimal (monthly or fewer) symptoms (KCCQ-SF, ≥75) when treated at one practice versus another, at random. The mean (±SD) KCCQ-OS and KCCQ-SF were 64.2±24 and 68.9±25.6, with 40% (n=1380) and 50% (n=1760) having KCCQ scores ≥75, respectively. The adjusted median odds ratio across practices, for KCCQ-OS ≥75, was 1.70 (95% confidence interval, 1.54-1.99; <0.001) indicating a median 70% higher odds of a patient having good-to-excellent health status when treated at one random practice versus another. In regard to KCCQ-SF, the adjusted median odds ratio for KCCQ-SF ≥75 was 1.54 (95% confidence interval, 1.41-1.76; =0.001).

Conclusions: In a large, contemporary registry of outpatients with chronic heart failure with reduced ejection fraction, we observed significant practice-level variability in patients' health status. Quantifying patients' health status as a measure of quality should be explored as a foundation for improving care.

Clinical Trial Registration: URL: https://www.centerwatch.com. Unique identifier: TX144901.

Citing Articles

Reliability and Validity of Kansas City Cardiomyopathy Questionnaire in Arabic Patients with Chronic Heart Failure.

Albarrati A, Altimani R, Almogbel O, Alnahdi A, Almurdi M, Abuammah A Medicina (Kaunas). 2023; 59(11).

PMID: 38003959 PMC: 10673578. DOI: 10.3390/medicina59111910.

You're Not Who You Used to Be: A Case Report of a Family Living with Heart Failure and Vascular Dementia.

Young S, Smith M, Shafique S, Piamjariyakul U Home Healthc Now. 2023; 41(3):140-148.

PMID: 37144929 PMC: 11168254. DOI: 10.1097/NHH.0000000000001165.

Identifying patients at increased risk for poor outcomes from heart failure with reduced ejection fraction: the PROMPT-HF risk model.

DeVore A, Hill C, Thomas L, Albert N, Butler J, Patterson J ESC Heart Fail. 2021; 9(1):178-185.

PMID: 34791838 PMC: 8787961. DOI: 10.1002/ehf2.13709.

Risk Adjustment Model for Preserved Health Status in Patients With Heart Failure and Reduced Ejection Fraction: The CHAMP-HF Registry.

Tran A, Fonarow G, Arnold S, Jones P, Thomas L, Hill C Circ Cardiovasc Qual Outcomes. 2021; 14(10):e008072.

PMID: 34615366 PMC: 8530961. DOI: 10.1161/CIRCOUTCOMES.121.008072.

Patient-Reported Outcomes in Patients with Cardiomyopathy.

Garcia R, Benton M, Spertus J Curr Cardiol Rep. 2021; 23(7):91.

PMID: 34121150 PMC: 9264335. DOI: 10.1007/s11886-021-01511-5.

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