adherence enrollment 1 21/07/2017 The primary goal of the New - PDF document

21/07/2017 Guideline Registry adherence enrollment 1

21/07/2017 The primary goal of the New Zealand Heart Failure Registry is to improve the medical care of heart failure patients, through a better understanding of patients demographics, management, and in- hospital and post-discharge outcomes (2006) 2006 – Dec 2015 Stand-alone Web Based ADHF form within ANZACS-QI Comprehensive data set Some simplification of the dataset possible 90 day follow-up data required a phone call No follow-up data collected 2

21/07/2017 3

21/07/2017 4

21/07/2017 5

21/07/2017 6

21/07/2017 • To develop a national network of audit sites 7

21/07/2017 Overall (n=119) 60 Age yrs – Median (IQR) 77 (63-83) 54.6 50 Male gender 64.7% Percent cohort 40 Ethnicity, n(%) Maaori 18 (15.1) 30 Pacific 16 (13.4) 28.6 Indian 5 (4.2) 20 Other Asian 3 (2.5) European/Other 77 (64.7) 10 10.1 2.5 2.5 1.7 Northern Region 49.6% 0 20-29 30-39 40-49 50-59 60-74 75+ Death in hospital, n(%) 5 (4.2) Age ranges 8

21/07/2017 • To compare patient characteristics of “selective” vs consecutive enrollments Snapshot (n=119) Other 2016 patients (n=929) P-value Complete capture? Selective capture? Age yrs – Median (IQR) 77 (63-83) 73 (60-81) 0.043 Male gender 64.7% 64.7% 1.00 Ethnicity, n(%) Maaori 18 (15.1) 240 (26.0) 0.013 Pacific 16 (13.4) 78 (8.4) Indian 5 (4.2) 23 (2.5) Other Asian 3 (2.5) 7 (0.8) European/Other 77 (64.7) 572 (61.9) Region, (%) Northern 46.9 26.6 <0.0001 Midlands 16.8 48.6 Central 12.6 18.5 Southern 21.0 6.3 9

21/07/2017 Middlemore Rest of hospitals P-value Hospital (n=24) (n=95) Age yrs 0.005 Mean ± SD 64.2 ± 16.8 74.5 ± 13.6 Median (IQR) 66 (54-77.5) 79 (65-84) Range 28 -90 23-94 Ethnicity, n(%) 0.002 Maaori/Pacific 13 (54.2) 21 (22.1) Others 11 (45.8) 74 (77.9) • To review adherence to class I guideline recommendations 10

21/07/2017 11

21/07/2017 Overall Echo No Echo P-value (n=119) (n=86, 72%) (n=33, 28%) Age - Median 77 (63-84) 74.5 (63-83) 80 (69-85) 0.07 (IQR) Male gender 64.7 69.8 51.5 0.06 (%) Region Between region variability 0.49 Hospital Between hospital variability 0.02 12

21/07/2017 LVEF ≤ 40% LVEF > 40% Unknown EF No Echo P-Value (n = 48) (n = 27) (n = 7) (n = 32) Beta-blockers 29 (60.4%) 18 (66.7%) 3 (42.9%) 22 (68.8%) 0.58 ACEi/ARB 30 (62.5%) 17 (63%) 5 (71.4%) 19 (59.4%) 0.97 Aldosterone 16 (33.3%) 4 (14.8%) 2 (28.6%) 5 (15.6%) 0.18 antagonist All 3 classes 11 (22.9%) 2 (7.4%) 0 (0%) 4 (12.5%) 0.24 13

21/07/2017 14

21/07/2017 Marisa van Arragon, Helen McGrinder, Julie Chirnside Mildred Ah Wei Andrew Kerr Middlemore Cardiac Trust 15