Investigating Variation in Hospital Acute Coronary Syndrome Outcomes

Acute Myocardial Infarction Clinical Trial

Official title:

Evaluation of the Methods and Management of Acute Coronary Events-4: Investigating Variation in Hospital Acute Coronary Syndrome Outcomes

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01819103
• Other study ID #: 12/WM/0431
• Status: Completed
• Phase: N/A
• First received: March 23, 2013
• Last updated: April 3, 2013
• Start date: March 2011
• Est. completion date: March 2013

Study information

• Verified date: April 2013
• Source: University of Leeds
• Contact: n/a
• Is FDA regulated: No
• Health authority: United Kingdom: Research Ethics Committee
• Study type: Observational [Patient Registry]

Clinical Trial Summary

To investigate the causes of hospital variation in outcomes from acute coronary syndromes in England and develop recommendations for improving patient care.

Description:

Over the last few years the chance of dying from a heart attack in England and Wales has reduced dramatically. Even so, there remain huge differences in mortality between hospitals. For example, up to a third of patients with a heart attack who attend hospitals in England are more likely to die than would be expected. That is, the type of treatment and the risk of death depend upon where a patient lives and which hospital they attend. In part, the variation in death may be due to the services available at the hospital or to factors such as socioeconomic deprivation. It may also relate to other factors such as depression, cardiac rehabilitation, patient experience of hospital care and whether patients take their medication after discharge from hospital.

Notably, the challenges posed by poor drug adherence to secondary prevention medications are recognised by the World Health Organisation as the highest area of priority for improving individual health throughout the world. In addition, Patient Reported Outcome Measures (PROMs) are set to be the cornerstone of the evaluation of patient experiences of National Health Service quality of care.

Using statistical approaches that include measures of quality of life, we propose to examine data about heart attacks in England and investigate the 'postcode lottery of care'. Our aim, using regional data about heart attacks is to identify and measure the effects of hospital care. This research will identify hospital qualities that promote improved patient care. In doing so, best practice will be highlighted and healthcare policy changed so that all patients will have an equal chance of surviving a heart attack.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 5555
• Est. completion date: March 2013
• Est. primary completion date: February 2013
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

Age > 18 years, both sexes, acute admission to the acute Trust with suspected acute coronary syndrome (ACS).

Exclusion Criteria:

Patients at a terminal stage of any illness, and those in whom follow up would be inappropriate or impractical.

Study Design

Observational Model: Cohort, Time Perspective: Prospective

Related Conditions & MeSH terms

• Acute Coronary Syndrome
• Acute Myocardial Infarction
• Infarction
• Myocardial Infarction

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
University of Leeds

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Health related quality of life assessement		12 month	No
Primary	Mortality		12 months	No
Secondary	Drug Adherence		12 month	Yes