TY - JOUR
T1 - Adherence to guidelines in the clinical care for adults with congenital heart disease
T2 - The Euro Heart Survey on Adult Congenital Heart Disease
AU - Engelfriet, Peter
AU - Tijssen, Jan
AU - Kaemmerer, Harald
AU - Gatzoulis, Michael A.
AU - Boersma, Eric
AU - Oechslin, Erwin
AU - Thaulow, Erik
AU - Popelová, Jana
AU - Moons, Philip
AU - Meijboom, Folkert
AU - Daliento, Luciano
AU - Hirsch, Rafael
AU - Laforest, Valérie
AU - Thilén, Ulf
AU - Mulder, Barbara
PY - 2006/3
Y1 - 2006/3
N2 - Aims: To investigate the role of guidelines in structuring the clinical care for adult patients with congenital heart disease (CHD), and to assess adherence to the guidelines in Europe. Methods and results: A selected number of current guidelines were chosen pertaining to operative procedures, investigations, and the use of medication ('interventions'). The source for this analysis was the database of the Euro Heart Survey on adult CHD, which contains retrospectively collected data on 4110 patients followed-up for a median of 5.1 years. For each guideline investigated, patients were selected from the database for whom the particular guideline was relevant. The selected cases were classified according to two criteria: was there an indication for the particular intervention and did the intervention take place? In this manner, cases of 'undue treatment' and 'insufficient treatment' were identified. Adherence to guidelines was found to be good in the case of operative procedures and prophylactic drug treatment. However, regarding diagnostic procedures there had been adherence to guidelines in only slightly more than half of the cases. Conclusion: Guidelines have an important role in the actual clinical care of adults with CHD. However, large outcome studies are needed to develop more precise guidelines.
AB - Aims: To investigate the role of guidelines in structuring the clinical care for adult patients with congenital heart disease (CHD), and to assess adherence to the guidelines in Europe. Methods and results: A selected number of current guidelines were chosen pertaining to operative procedures, investigations, and the use of medication ('interventions'). The source for this analysis was the database of the Euro Heart Survey on adult CHD, which contains retrospectively collected data on 4110 patients followed-up for a median of 5.1 years. For each guideline investigated, patients were selected from the database for whom the particular guideline was relevant. The selected cases were classified according to two criteria: was there an indication for the particular intervention and did the intervention take place? In this manner, cases of 'undue treatment' and 'insufficient treatment' were identified. Adherence to guidelines was found to be good in the case of operative procedures and prophylactic drug treatment. However, regarding diagnostic procedures there had been adherence to guidelines in only slightly more than half of the cases. Conclusion: Guidelines have an important role in the actual clinical care of adults with CHD. However, large outcome studies are needed to develop more precise guidelines.
KW - Adherence to guidelines
KW - Adult
KW - Congenital heart disease
KW - Euro Heart Survey
UR - http://www.scopus.com/inward/record.url?scp=33644977647&partnerID=8YFLogxK
U2 - 10.1093/eurheartj/ehi718
DO - 10.1093/eurheartj/ehi718
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C2 - 16401672
AN - SCOPUS:33644977647
SN - 0195-668X
VL - 27
SP - 737
EP - 745
JO - European Heart Journal
JF - European Heart Journal
IS - 6
ER -
