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中国改善心血管疾病护理(CCC)项目的基本原理与设计:一项旨在改善房颤管理的全国性登记研究。

Rationale and design of the improving Care for Cardiovascular Disease in China (CCC) project: a national registry to improve management of atrial fibrillation.

作者信息

Hao Yongchen, Liu Jing, Smith Sidney C, Huo Yong, Fonarow Gregg C, Ge Junbo, Liu Jun, Taubert Kathryn A, Morgan Louise, Guo Yang, Zhou Mengge, Zhao Dong, Ma Changsheng

机构信息

Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.

Division of Cardiology, University of North Carolina, Chapel Hill, North Carolina, USA.

出版信息

BMJ Open. 2018 Jul 5;8(7):e020968. doi: 10.1136/bmjopen-2017-020968.

Abstract

INTRODUCTION

Inadequate management of patients with atrial fibrillation (AF) has been reported in China for anticoagulation therapy and treatment for concomitant diseases. An effective quality improvement programme has been lacking to promote the use of evidence-based treatments and improve outcome in patients with AF.

METHODS AND ANALYSIS

The Improving Care for Cardiovascular Disease in China-AF programme is a collaboration of the American Heart Association and the Chinese Society of Cardiology. This programme is designed to promote adherence to AF guideline recommendations and outcomes for inpatients with AF. Launched in February 2015, 150 hospitals are recruited by geographic-economic regions across 30 provinces in China. Each month, 10-20 inpatients with AF are enrolled in each hospital. A web-based data collection platform is used to collect clinical information for patients with AF, including patients' demographics, admission information, medical history, in-hospital care and outcomes, and discharge medications for managing AF. The quality improvement initiative includes monthly benchmarked reports on hospital quality, training sessions, regular webinars and recognitions of hospital quality achievement. Primary analyses will include adherence to performance measures and guidelines. To address intrahospital correlation, generalised estimating equation models will be applied. As of March 2017, 28 801 AF inpatients have been enrolled.

ETHICS AND DISSEMINATION

This study protocol was approved by the Ethics Committee of Beijing Anzhen Hospital, Capital Medical University. Results will be published in peer-reviewed medical journals.

TRIAL REGISTRATION NUMBER

NCT02309398.

摘要

引言

据报道,中国房颤(AF)患者在抗凝治疗及合并疾病治疗方面存在管理不足的情况。目前缺乏有效的质量改进计划来促进循证治疗的应用并改善房颤患者的预后。

方法与分析

“中国改善心血管疾病治疗——房颤项目”是美国心脏协会与中国心脏学会的合作项目。该项目旨在促进房颤住院患者遵循房颤指南建议并改善预后。于2015年2月启动,在中国30个省份按地理经济区域招募了150家医院。每家医院每月纳入10 - 20例房颤住院患者。使用基于网络的数据收集平台收集房颤患者的临床信息,包括患者人口统计学资料、入院信息、病史、住院治疗及转归,以及用于管理房颤的出院用药。质量改进举措包括每月发布的医院质量基准报告、培训课程、定期网络研讨会以及对医院质量成就的表彰。主要分析将包括对性能指标和指南的遵循情况。为处理医院内部的相关性,将应用广义估计方程模型。截至2017年3月,已纳入28801例房颤住院患者。

伦理与传播

本研究方案已获首都医科大学附属北京安贞医院伦理委员会批准。研究结果将在同行评审的医学期刊上发表。

试验注册号

NCT02309398。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4962/6135416/f5fe81eaad12/bmjopen-2017-020968f01.jpg

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