Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Clin Cardiol. 2012;35(7):396-403. doi: 10.1002/clc.22023.
Successful smoking cessation in stroke and coronary artery disease (CAD) patients is important, as smoking contributes to significant morbidity and mortality. The American Heart Association developed Get With The Guidelines (GWTG) to improve compliance with national guideline recommendations for cardiovascular care. Using data from GWTG, we examined trends associated with the smoking-cessation counseling (SCC) performance measure.
Implementation of a systematic quality improvement program will increase compliance with the SCC performance measure.
We evaluated compliance with SCC in current or recent smokers identified from 224 671 CAD admissions between 2002 and 2008 in the GWTG-CAD database, and from 405 681 stroke admissions between 2002 and 2007 in the GWTG-Stroke database. Additionally, we examined adherence to other performance and quality measures related to CAD and stroke care.
Overall, 55 904 GWTG-CAD and 58 865 GWTG-Stroke admissions were used for the analysis. Rates of SCC improved in each successive year during the study, from 67.6% to 97.4% (P < 0.001) in GWTG-CAD and from 40.1% to 90.7% (P < 0.001) in GWTG-Stroke. Compliance with SCC was up to 34.7% lower (P < 0.0001) in GWTG-Stroke compared with GWTG-CAD, but this difference decreased to 6.7% (P < 0.0001) by the end of the study period. Compliance with many other performance and quality measures was significantly lower among patients not receiving SCC.
Get With The Guidelines has improved compliance with the SCC performance measure among patients with CAD and stroke. Although the initial disparity in rates of SCC between CAD and stroke patients gradually improved, the difference remained significant.
成功帮助中风和冠状动脉疾病（CAD）患者戒烟非常重要，因为吸烟会导致严重的发病率和死亡率。美国心脏协会制定了 Get With The Guidelines（GWTG），以改善心血管护理的国家指南建议的依从性。利用 GWTG 数据，我们研究了与戒烟咨询（SCC）绩效测量相关的趋势。
实施系统的质量改进计划将提高 SCC 绩效测量的依从性。
我们评估了 2002 年至 2008 年 GWTG-CAD 数据库中 224671 例 CAD 入院和 2002 年至 2007 年 GWTG-Stroke 数据库中 405681 例中风入院的当前或近期吸烟者的 SCC 依从性。此外，我们还研究了其他与 CAD 和中风护理相关的绩效和质量措施的依从性。
在整个研究期间，每年的 SCC 率都有所提高，GWTG-CAD 从 67.6%提高到 97.4%（P<0.001），GWTG-Stroke 从 40.1%提高到 90.7%（P<0.001）。与 GWTG-CAD 相比，GWTG-Stroke 的 SCC 依从性低了 34.7%（P<0.0001），但在研究结束时，这一差异缩小到 6.7%（P<0.0001）。未接受 SCC 的患者其他许多绩效和质量措施的依从性明显较低。
Get With The Guidelines 提高了 CAD 和中风患者对 SCC 绩效测量的依从性。尽管 CAD 和中风患者之间 SCC 率的初始差异逐渐改善，但差异仍然显著。
