Cardiology Practices With APNs, PAs Meet Guidelines

In some cases, practices with these staff members adhere to guidelines better than those without
By Jeff Muise
HealthDay Reporter

MONDAY, June 21 (HealthDay News) -- Cardiology practices with at least two advanced practice nurses (APNs) or physician assistants (PAs) on staff deliver most guideline-recommended heart failure outpatient therapies as well as practices with no APNs or PAs, and deliver some therapies and services better, according to a study in the June 15 issue of the American Journal of Cardiology.

Nancy M. Albert, Ph.D., of the Cleveland Clinic, and colleagues in the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF) assessed the adherence to seven guideline-recommended therapies by 167 cardiology practices treating 15,381 patients with chronic heart failure and reduced left ventricular ejection fraction.

The researchers found that 66 percent of the practices had APNs and PAs assigned. Compared with practices with no APNs or PAs, those with two or more APNs or PAs displayed greater conformity to the two guidelines recommending implantable cardioverter-defibrillator therapy and delivery of heart failure education, but similar conformity to the other five, including angiotensin-converting enzyme inhibitor/angiotensin receptor blocker therapy, β-blocker therapy, aldosterone antagonist therapy, anticoagulation for atrial fibrillation, and cardiac resynchronization therapy.

"Importantly, there were no significant negative associations in the delivery of guideline-recommended heart failure therapies on the basis of APN and PA staffing," the authors write.

IMPROVE HF and the present study were sponsored by Medtronic Inc.

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