Medtronic-Supported Study is one of First to Evaluate Improvements, by Race, in the Use of Heart Failure Therapies in the Outpatient Setting

MINNEAPOLIS – Medtronic, Inc. today announced new findings from the landmark IMPROVE HF (Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting) trial, which showed equivalent improvements in the care of heart failure patients across all races and ethnicities when evidence-based, performance improvement interventions were applied in outpatient settings. The performance improvement interventions included clinical-decision support tools, structured improvement strategies (including patient assessment and management forms, and patient education materials) and patient chart reviews with performance feedback.  

The majority of baseline differences in care among race groups studied were reduced or eliminated at 24 months, post-intervention. Funded by Medtronic and recently published in the Journal of the National Medical Association, the study is among the first to assess improvements in the use of clinical guideline-recommended heart failure therapies by race in the outpatient cardiology practice setting.

“While African Americans are at greater risk for developing heart failure at an earlier age and at increased risk for disease-related complications and death, studies show that these patients are less likely to receive guideline-recommended medication and device therapies to treat their debilitating condition,” said Clyde W. Yancy, M.D., co-chair of the IMPROVE HF steering committee and chief of the Division of Cardiology at Northwestern Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago. “These new findings from the IMPROVE HF registry are provocative, as they demonstrate that physician education initiatives have the potential to help eradicate disparities in care and therefore greatly improve overall clinical outcomes for heart failure patients of all races.”

Seven quality measures were analyzed in the IMPROVE HF study, including use of drug therapy (ACE inhibitors or angiotensin receptor blockers, beta-blockers, aldosterone antagonists and anticoagulants for atrial fibrillation); use of implantable device treatments such as implantable cardioverter defibrillators (ICDs) and cardiac resynchronization therapy (CRT) with a defibrillator or pacemaker; and heart failure patient education. Following implementation of the IMPROVE HF physician-based performance interventions, statistically significant improvements in the use of CRT device therapy, aldosterone antagonist drugs and heart failure education were observed across all race groups studied.

As confirmed in this study, many physicians do not document race or ethnicity in the outpatient medical chart. However, results from IMPROVE HF demonstrate that improvements in outpatient care and overall treatment adherence were achieved regardless of whether the patient race was African American, Caucasian or undocumented. Of the 7605 patients analyzed in the retrospective study, 9 percent were African American, 42.6 percent were Caucasian and 46.5 percent were undocumented in terms of race. Specifically, at 24-months post-intervention:

• CRT devices were used in 67.3 percent of African Americans (25.7 percent change from baseline, p <.001), 71.3 percent of Caucasians (29.3 percent change from baseline, p <.001) and 65.6 percent of race undocumented patients (25.4 percent change from baseline, p <.001).
• Aldosterone antagonists were used in 76 percent of African Americans (24.8 percent change from baseline, p <.001), 59 percent of Caucasians (24 percent change from baseline, p <.001) and 58.2 percent of race undocumented patients (28.1 percent change from baseline).
• Heart failure educational tools were applied with 78.4 percent of African Americans (15.2 percent change from baseline, p <.001), 72.5 percent of Caucasians (12.4 percent change from baseline, p <.001) and 67.8 percent of race undocumented patients (9.1 percent change from baseline, p <.001).

“This research represents a significant milestone demonstrating our commitment to innovation in identifying the best, most clinically advanced solutions for ensuring patient quality of care,” said David Steinhaus, M.D., Vice President and General Manager, Heart Failure, and Medical Director for the Cardiac Rhythm Disease Management business at Medtronic. “Current guidelines recommend the use of evidence-based medication and device therapy for heart failure patients of all races and ethnicities, and through implementation of IMPROVE HF performance improvement interventions, this could ultimately be achieved.”

Source: Medtronic, Inc.