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

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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,

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Guideline adherence Registry enrollment

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21/07/2017 2 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 Comprehensive data set 90 day follow-up data required a phone call ADHF form within ANZACS-QI Some simplification of the dataset possible No follow-up data collected

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To develop a national network of audit sites

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Overall (n=119) Age yrs – Median (IQR) 77 (63-83) Male gender 64.7% Ethnicity, n(%) Maaori Pacific Indian Other Asian European/Other 18 (15.1) 16 (13.4) 5 (4.2) 3 (2.5) 77 (64.7) Northern Region 49.6% Death in hospital, n(%) 5 (4.2)

1.7 2.5 2.5 10.1 28.6 54.6 10 20 30 40 50 60 20-29 30-39 40-49 50-59 60-74 75+

Age ranges Percent cohort

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To compare patient characteristics of “selective” vs consecutive

enrollments

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

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

To review adherence to class I guideline recommendations

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

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LVEF ≤ 40% (n = 48) LVEF > 40% (n = 27) Unknown EF (n = 7) No Echo (n = 32) P-Value 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 antagonist 16 (33.3%) 4 (14.8%) 2 (28.6%) 5 (15.6%) 0.18 All 3 classes 11 (22.9%) 2 (7.4%) 0 (0%) 4 (12.5%) 0.24

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