SUrvey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World (SUGAR): a multi-center, retrospective, observational study
Clinical practice guidelines have been slowly and inconsistently applied in clinical practice, and certain evidence-based, guideline-driven therapies for heart failure (HF) have been significantly underused. The purpose of this study was to survey guideline compliance and its effect on clinical outc...
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| Veröffentlicht in: | PloS one 2014-01, Vol.9 (1), p.e86596-e86596 |
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| creator | Yoo, Byung-Su Oh, Jaewon Hong, Bum-Kee Shin, Dae-Hee Bae, Jang-Ho Yang, Dong Heon Shim, Wan-Joo Kim, Hyung-Seop Kim, Su-Hong Choi, Jin-Oh Chun, Woo-Jung Go, Choong-Won Kang, Hyun-Jae Baek, Sang Hong Cho, Jang-Hyun Hong, Suk-Keun Shin, Joon-Han Oh, Seok-Kyu Pyun, Wook-Bum Kwan, Jun Hong, Young-Joon Jeong, Jin-Ok Kang, Seok-Min Choi, Dong-Ju |
| description | Clinical practice guidelines have been slowly and inconsistently applied in clinical practice, and certain evidence-based, guideline-driven therapies for heart failure (HF) have been significantly underused. The purpose of this study was to survey guideline compliance and its effect on clinical outcomes in the treatment of systolic HF in Korea.
The SUrvey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World (SUGAR) trial was a multi-center, retrospective, observational study on subjects with systolic HF (ejection fraction |
| doi_str_mv | 10.1371/journal.pone.0086596 |
| format | Article |
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The SUrvey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World (SUGAR) trial was a multi-center, retrospective, observational study on subjects with systolic HF (ejection fraction <45%) admitted to 23 university hospitals. The guideline adherence indicator (GAI) was defined as a performance measure on the basis of 3 pharmacological classes: angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor II blocker (ARB), beta-blocker (BB), and aldosterone antagonist (AA). Based on the overall adherence percentage, subjects were divided into 2 groups: those with good guideline adherence (GAI ≥50%) and poor guideline adherence (GAI <50%). We included 1319 regional participants as representatives of the standard population from the Korean national census in 2008. Adherence to drugs at discharge was as follows: ACEI or ARB, 89.7%; BB, 69.2%; and AA, 65.9%. Overall, 82.7% of the patients had good guideline adherence. Overall mortality and re-hospitalization rates at 1 year were 6.2% and 37.4%, respectively. Survival analysis by log-rank test showed a significant difference in event-free survival rate of mortality (94.7% vs. 89.8%, p = 0.003) and re-hospitalization (62.3% vs. 56.4%, p = 0.041) between the good and poor guideline-adherence groups.
Among patients with systolic HF in Korea, adherence to pharmacologic treatment guidelines as determined by performance measures, including prescription of ACEI/ARB and BB at discharge, was associated with improved clinical outcomes.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0086596</identifier><identifier>PMID: 24475154</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adhesion ; Adrenergic beta-Antagonists - therapeutic use ; Age Factors ; Aged ; Aldosterone ; Angiotensin ; Angiotensin Receptor Antagonists - therapeutic use ; Angiotensin-converting enzyme inhibitors ; Angiotensin-Converting Enzyme Inhibitors - therapeutic use ; Angiotensins ; Beta blockers ; Biology ; Cardiology ; Data Collection - methods ; Diabetes ; Discharge ; Drug therapy ; Drugs ; Enzyme inhibitors ; Evidence-based medicine ; Evidence-Based Medicine - methods ; Evidence-Based Medicine - trends ; Female ; Guidelines ; Health aspects ; Heart diseases ; Heart failure ; Heart Failure, Systolic - drug therapy ; Hospital patients ; Humans ; Male ; Medical services ; Medication Adherence - statistics & numerical data ; Medicine ; Mineralocorticoid Receptor Antagonists - therapeutic use ; Morbidity ; Mortality ; Observational studies ; Patient compliance ; Patients ; Peptidyl-dipeptidase A ; Pharmacology ; Population ; Practice guidelines (Medicine) ; Republic of Korea ; Retrospective Studies ; Sex Factors ; Socioeconomic Factors ; Sugar ; Surveys ; Survival ; Treatment Outcome</subject><ispartof>PloS one, 2014-01, Vol.9 (1), p.e86596-e86596</ispartof><rights>COPYRIGHT 2014 Public Library of Science</rights><rights>2014 Yoo et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2014 Yoo et al 2014 Yoo et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c593t-6ef83674b83505aa99edd635d3e43337483bf2ccab8dee41c3669bbfce232c5b3</citedby><cites>FETCH-LOGICAL-c593t-6ef83674b83505aa99edd635d3e43337483bf2ccab8dee41c3669bbfce232c5b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3903552/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3903552/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,2915,23847,27905,27906,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24475154$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Malaga, German</contributor><creatorcontrib>Yoo, Byung-Su</creatorcontrib><creatorcontrib>Oh, Jaewon</creatorcontrib><creatorcontrib>Hong, Bum-Kee</creatorcontrib><creatorcontrib>Shin, Dae-Hee</creatorcontrib><creatorcontrib>Bae, Jang-Ho</creatorcontrib><creatorcontrib>Yang, Dong Heon</creatorcontrib><creatorcontrib>Shim, Wan-Joo</creatorcontrib><creatorcontrib>Kim, Hyung-Seop</creatorcontrib><creatorcontrib>Kim, Su-Hong</creatorcontrib><creatorcontrib>Choi, Jin-Oh</creatorcontrib><creatorcontrib>Chun, Woo-Jung</creatorcontrib><creatorcontrib>Go, Choong-Won</creatorcontrib><creatorcontrib>Kang, Hyun-Jae</creatorcontrib><creatorcontrib>Baek, Sang Hong</creatorcontrib><creatorcontrib>Cho, Jang-Hyun</creatorcontrib><creatorcontrib>Hong, Suk-Keun</creatorcontrib><creatorcontrib>Shin, Joon-Han</creatorcontrib><creatorcontrib>Oh, Seok-Kyu</creatorcontrib><creatorcontrib>Pyun, Wook-Bum</creatorcontrib><creatorcontrib>Kwan, Jun</creatorcontrib><creatorcontrib>Hong, Young-Joon</creatorcontrib><creatorcontrib>Jeong, Jin-Ok</creatorcontrib><creatorcontrib>Kang, Seok-Min</creatorcontrib><creatorcontrib>Choi, Dong-Ju</creatorcontrib><creatorcontrib>SUGAR Study</creatorcontrib><creatorcontrib>on behalf of the SUGAR Study</creatorcontrib><title>SUrvey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World (SUGAR): a multi-center, retrospective, observational study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Clinical practice guidelines have been slowly and inconsistently applied in clinical practice, and certain evidence-based, guideline-driven therapies for heart failure (HF) have been significantly underused. The purpose of this study was to survey guideline compliance and its effect on clinical outcomes in the treatment of systolic HF in Korea.
The SUrvey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World (SUGAR) trial was a multi-center, retrospective, observational study on subjects with systolic HF (ejection fraction <45%) admitted to 23 university hospitals. The guideline adherence indicator (GAI) was defined as a performance measure on the basis of 3 pharmacological classes: angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor II blocker (ARB), beta-blocker (BB), and aldosterone antagonist (AA). Based on the overall adherence percentage, subjects were divided into 2 groups: those with good guideline adherence (GAI ≥50%) and poor guideline adherence (GAI <50%). We included 1319 regional participants as representatives of the standard population from the Korean national census in 2008. Adherence to drugs at discharge was as follows: ACEI or ARB, 89.7%; BB, 69.2%; and AA, 65.9%. Overall, 82.7% of the patients had good guideline adherence. Overall mortality and re-hospitalization rates at 1 year were 6.2% and 37.4%, respectively. Survival analysis by log-rank test showed a significant difference in event-free survival rate of mortality (94.7% vs. 89.8%, p = 0.003) and re-hospitalization (62.3% vs. 56.4%, p = 0.041) between the good and poor guideline-adherence groups.
Among patients with systolic HF in Korea, adherence to pharmacologic treatment guidelines as determined by performance measures, including prescription of ACEI/ARB and BB at discharge, was associated with improved clinical outcomes.</description><subject>Adhesion</subject><subject>Adrenergic beta-Antagonists - therapeutic use</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aldosterone</subject><subject>Angiotensin</subject><subject>Angiotensin Receptor Antagonists - therapeutic use</subject><subject>Angiotensin-converting enzyme inhibitors</subject><subject>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</subject><subject>Angiotensins</subject><subject>Beta blockers</subject><subject>Biology</subject><subject>Cardiology</subject><subject>Data Collection - methods</subject><subject>Diabetes</subject><subject>Discharge</subject><subject>Drug therapy</subject><subject>Drugs</subject><subject>Enzyme inhibitors</subject><subject>Evidence-based medicine</subject><subject>Evidence-Based Medicine - methods</subject><subject>Evidence-Based Medicine - trends</subject><subject>Female</subject><subject>Guidelines</subject><subject>Health aspects</subject><subject>Heart diseases</subject><subject>Heart failure</subject><subject>Heart Failure, Systolic - drug therapy</subject><subject>Hospital patients</subject><subject>Humans</subject><subject>Male</subject><subject>Medical services</subject><subject>Medication Adherence - statistics & numerical data</subject><subject>Medicine</subject><subject>Mineralocorticoid Receptor Antagonists - therapeutic use</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Observational studies</subject><subject>Patient compliance</subject><subject>Patients</subject><subject>Peptidyl-dipeptidase A</subject><subject>Pharmacology</subject><subject>Population</subject><subject>Practice guidelines (Medicine)</subject><subject>Republic of Korea</subject><subject>Retrospective Studies</subject><subject>Sex Factors</subject><subject>Socioeconomic Factors</subject><subject>Sugar</subject><subject>Surveys</subject><subject>Survival</subject><subject>Treatment 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Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yoo, Byung-Su</au><au>Oh, Jaewon</au><au>Hong, Bum-Kee</au><au>Shin, Dae-Hee</au><au>Bae, Jang-Ho</au><au>Yang, Dong Heon</au><au>Shim, Wan-Joo</au><au>Kim, Hyung-Seop</au><au>Kim, Su-Hong</au><au>Choi, Jin-Oh</au><au>Chun, Woo-Jung</au><au>Go, Choong-Won</au><au>Kang, Hyun-Jae</au><au>Baek, Sang Hong</au><au>Cho, Jang-Hyun</au><au>Hong, Suk-Keun</au><au>Shin, Joon-Han</au><au>Oh, Seok-Kyu</au><au>Pyun, Wook-Bum</au><au>Kwan, Jun</au><au>Hong, Young-Joon</au><au>Jeong, Jin-Ok</au><au>Kang, Seok-Min</au><au>Choi, Dong-Ju</au><au>Malaga, German</au><aucorp>SUGAR Study</aucorp><aucorp>on behalf of the SUGAR Study</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>SUrvey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World (SUGAR): a multi-center, retrospective, observational study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2014-01-27</date><risdate>2014</risdate><volume>9</volume><issue>1</issue><spage>e86596</spage><epage>e86596</epage><pages>e86596-e86596</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Clinical practice guidelines have been slowly and inconsistently applied in clinical practice, and certain evidence-based, guideline-driven therapies for heart failure (HF) have been significantly underused. The purpose of this study was to survey guideline compliance and its effect on clinical outcomes in the treatment of systolic HF in Korea.
The SUrvey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World (SUGAR) trial was a multi-center, retrospective, observational study on subjects with systolic HF (ejection fraction <45%) admitted to 23 university hospitals. The guideline adherence indicator (GAI) was defined as a performance measure on the basis of 3 pharmacological classes: angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor II blocker (ARB), beta-blocker (BB), and aldosterone antagonist (AA). Based on the overall adherence percentage, subjects were divided into 2 groups: those with good guideline adherence (GAI ≥50%) and poor guideline adherence (GAI <50%). We included 1319 regional participants as representatives of the standard population from the Korean national census in 2008. Adherence to drugs at discharge was as follows: ACEI or ARB, 89.7%; BB, 69.2%; and AA, 65.9%. Overall, 82.7% of the patients had good guideline adherence. Overall mortality and re-hospitalization rates at 1 year were 6.2% and 37.4%, respectively. Survival analysis by log-rank test showed a significant difference in event-free survival rate of mortality (94.7% vs. 89.8%, p = 0.003) and re-hospitalization (62.3% vs. 56.4%, p = 0.041) between the good and poor guideline-adherence groups.
Among patients with systolic HF in Korea, adherence to pharmacologic treatment guidelines as determined by performance measures, including prescription of ACEI/ARB and BB at discharge, was associated with improved clinical outcomes.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>24475154</pmid><doi>10.1371/journal.pone.0086596</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2014-01, Vol.9 (1), p.e86596-e86596 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1492015322 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adhesion Adrenergic beta-Antagonists - therapeutic use Age Factors Aged Aldosterone Angiotensin Angiotensin Receptor Antagonists - therapeutic use Angiotensin-converting enzyme inhibitors Angiotensin-Converting Enzyme Inhibitors - therapeutic use Angiotensins Beta blockers Biology Cardiology Data Collection - methods Diabetes Discharge Drug therapy Drugs Enzyme inhibitors Evidence-based medicine Evidence-Based Medicine - methods Evidence-Based Medicine - trends Female Guidelines Health aspects Heart diseases Heart failure Heart Failure, Systolic - drug therapy Hospital patients Humans Male Medical services Medication Adherence - statistics & numerical data Medicine Mineralocorticoid Receptor Antagonists - therapeutic use Morbidity Mortality Observational studies Patient compliance Patients Peptidyl-dipeptidase A Pharmacology Population Practice guidelines (Medicine) Republic of Korea Retrospective Studies Sex Factors Socioeconomic Factors Sugar Surveys Survival Treatment Outcome |
| title | SUrvey of Guideline Adherence for Treatment of Systolic Heart Failure in Real World (SUGAR): a multi-center, retrospective, observational study |
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