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Adherence to Canadian best practice recommendations for stroke care: assessment and management of poststroke depression in an Ontario rehabilitation facility.

https://arctichealth.org/en/permalink/ahliterature125961
Source
Top Stroke Rehabil. 2012 Mar-Apr;19(2):132-40
Publication Type
Article
Author
Katherine Salter
J Andrew McClure
Hannah Mahon
Norine Foley
Robert Teasell
Author Affiliation
Lawson Health Research Institute, London, Ontario, Canada.
Source
Top Stroke Rehabil. 2012 Mar-Apr;19(2):132-40
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Databases, Factual - statistics & numerical data
Depressive Disorder - psychology - rehabilitation
Female
Guideline Adherence - standards
Health Personnel - standards
Humans
Male
Medical Audit
Middle Aged
Ontario
Practice Guidelines as Topic
Process Assessment (Health Care)
Retrospective Studies
Stroke - psychology - rehabilitation
Abstract
Although Canadian best practice recommendations regarding assessment and management of poststroke depression (PSD) have been established, the degree to which these evidence-based guidelines have been translated into practice is not known. The objectives of the present study are to compare current and recommended best practice and examine possible reasons for identified care gaps.
Practice audit by chart review was performed to identify recorded screening, assessment, and treatment for PSD in patients discharged from a specialized inpatient rehabilitation program over a 6-month period. A questionnaire was administered to all clinical staff addressing current screening practices as well as opinions regarding the importance and feasibility of identification and treatment of PSD.
Of 123 patients, 40 (32.5%) had been prescribed antidepressants at discharge. However, evidence of screening was found for 4.9% of patients; another 9.8% were referred for psychological consult. Treatment was associated with previous antidepressant use or history of depression, but not screening or assessment. Of the survey respondents, 56.2% were not aware of best practice recommendations. However, most felt screening and assessment to be important and treatment was regarded as both simple and effective.
Despite potential benefit associated with identification and treatment of PSD and the availability of evidence-based best practice recommendations, PSD may remain unrecognized and undertreated. Given the juxtaposition of perceived importance with the lack of documented best practice, education regarding standardized screening and the development of consistent clinical protocols including roles and responsibilities in the identification, diagnosis, and treatment of PSD are underway.
PubMed ID
22436361 View in PubMed
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Adherence to cancer screening guidelines across Canadian provinces: an observational study.

https://arctichealth.org/en/permalink/ahliterature142706
Source
BMC Cancer. 2010;10:304
Publication Type
Article
Date
2010
Author
Erin C Strumpf
Zhijin Chai
Srikanth Kadiyala
Author Affiliation
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC H3A 2T7, Canada. erin.strumpf@mcgill.ca
Source
BMC Cancer. 2010;10:304
Date
2010
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Breast Neoplasms - diagnosis - epidemiology - prevention & control
Canada - epidemiology
Colorectal Neoplasms - diagnosis - epidemiology - prevention & control
Cross-Sectional Studies
Early Detection of Cancer
Female
Guideline Adherence - standards
Humans
Male
Mass Screening
Middle Aged
Patient compliance
Practice Guidelines as Topic - standards
Prostatic Neoplasms - diagnosis - epidemiology - prevention & control
Abstract
Cancer screening guidelines reflect the costs and benefits of population-based screening based on evidence from clinical trials. While most of the existing literature on compliance with cancer screening guidelines only measures raw screening rates in the target age groups, we used a novel approach to estimate degree of guideline compliance across Canadian provinces for breast, colorectal and prostate cancer screening. Measuring compliance as the change in age-specific screening rates at the guideline-recommended initiation age (50), we generally found screening patterns across Canadian provinces that were not consistent with guideline compliance.
We calculated age-cancer-specific screening rates for ages 40-60 using the Canadian Community Health Survey (2003 and 2005), a cross-sectional, nationally representative survey of health status, health care utilization and health determinants in the Canadian population. We estimated the degree of compliance using logistic regression to measure the change in adjusted screening rates at the guideline-recommended initiation age for each province in the sample.
For breast cancer, after adjusting for age trends and other covariates, being above age 50 in Quebec increased the probability of being screened by 19 percentage points, from an average screening rate of 24% among 40-49 year olds. None of the other regions exhibited a statistically significant change in screening rates at age 50. Additional analyses indicated that these patterns reflect asymptomatic screening and that Quebec's breast cancer screening program enhanced the degree of guideline compliance in that province. Colorectal cancer screening practice was consistent with guidelines only in Saskatchewan, as screening rates increased at age 50 by 12 percentage points, from an average rate of 6% among 40-49 year olds. For prostate cancer, the regions examined here are not compliant with Canadian guidelines since screening rates were quite high, and there was not a discrete increase at any particular age.
Screening practice for breast, colorectal and prostate cancer was generally not consistent with Canadian clinical guidelines. Quebec (breast) and Saskatchewan (colorectal) were exceptions to this, and the impact of Quebec's breast cancer screening program suggests a role for policy in improving screening guideline compliance.
Notes
Cites: CMAJ. 2000 Oct 31;163(9):1133-811079057
Cites: N Engl J Med. 2009 Mar 26;360(13):1320-819297566
Cites: CMAJ. 2001 Feb 20;164(4):469-7611233866
Cites: CMAJ. 2001 Jul 24;165(2):206-811501466
Cites: Cancer Detect Prev. 2002;26(5):350-6112518865
Cites: Am J Epidemiol. 2003 May 15;157(10):940-312746247
Cites: Cancer Epidemiol Biomarkers Prev. 2003 Nov;12(11 Pt 1):1182-714652278
Cites: Can J Public Health. 1996 May-Jun;87(3):176-808771920
Cites: J Med Screen. 1998;5(2):73-809718525
Cites: CMAJ. 1998 Oct 6;159(7):797-89805027
Cites: Chronic Dis Can. 1998;19(3):112-309820835
Cites: Can J Public Health. 2005 Sep-Oct;96(5):364-816238156
Cites: Can J Public Health. 2006 May-Jun;97(3):171-616827400
Cites: Eur J Cancer Prev. 2008 Feb;17(1):48-5318090910
Cites: Can J Urol. 2007 Dec;14(6):3727-3318163923
Cites: BMC Gastroenterol. 2007;7:3917910769
Cites: Womens Health Issues. 2008 Mar-Apr;18(2):85-9918182305
Cites: N Engl J Med. 2009 Mar 26;360(13):1310-919297565
Cites: J Med Screen. 2000;7(3):152-911126165
PubMed ID
20565862 View in PubMed
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[Adherence to guidelines on management of acute coronary syndrome in Russian hospitals and outcomes of hospitalization (data from the RECORD-2 Registry)].

https://arctichealth.org/en/permalink/ahliterature115057
Source
Kardiologiia. 2013;53(1):14-22
Publication Type
Article
Date
2013
Author
A D Érlikh
M S Kharchenko
O L Barbarash
V V Kashtalap
M V Zykov
T B Pecherina
I I Shevchenko
R R Islamov
E D Kosmacheva
L K Kruberg
O A Pozdniakova
N G Goroshko
V A Markov
A G Syrkina
N V Belokopytova
V V Gorbunov
A S Gagarkina
T V Kalinkina
O A Zaitseva
S A Luk'ianov
D P Tagirova
V M Provotorov
N A Gratsianskii
Source
Kardiologiia. 2013;53(1):14-22
Date
2013
Language
Russian
Publication Type
Article
Keywords
Acute Coronary Syndrome - diagnosis - mortality - therapy
Aged
Diagnostic Techniques, Cardiovascular
Disease Management
Female
Guideline Adherence - standards - statistics & numerical data
Hospital Mortality
Hospitalization - statistics & numerical data
Humans
Male
Myocardial Revascularization - methods
Outcome and Process Assessment (Health Care)
Practice Guidelines as Topic
Registries - statistics & numerical data
Retrospective Studies
Risk assessment
Risk factors
Russia - epidemiology
Severity of Illness Index
Abstract
Complete following existing guidelines for management of acute coronary syndrome (ACS) is known to be associated with better outcomes. Partly this is explained by lesser adherence to recommendations in high risk patients. Aim of our study was to assess relationship between degree of following current guidelines and in hospital outcomes independently from initial assessment of risk.
Each key recommendation from guidelines issued between 2008 and 2011 (13 for STE ACS, 12 for NSTE ACS) was given weight of 1. Sum of these units constituted index of guideline adherence (IGA). IGA was retrospectively calculated for 1656 patients included in Russian independent ACS registry RECORD-2 (7 hospitals, duration 04.2009 to 04.2011). The patients were divided into 2 groups according to quartiles of IGA distribution: 1) low adherence group (quartiles I-II); 2) high adherence group (quartiles III-IV).
In low adherence compared with high adherence group there were significantly more patients more or equal 65 years (=0.0007), with chronic heart failure [CHF] (
PubMed ID
23548345 View in PubMed
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Adherence to national diabetes guidelines through monitoring quality indicators--A comparison of three types of care for the elderly with special emphasis on HbA1c.

https://arctichealth.org/en/permalink/ahliterature271560
Source
Prim Care Diabetes. 2015 Aug;9(4):253-60
Publication Type
Article
Date
Aug-2015
Author
Ann-Sofie Nilsson Neumark
Lars Brudin
Thomas Neumark
Source
Prim Care Diabetes. 2015 Aug;9(4):253-60
Date
Aug-2015
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Biomarkers - blood
Blood Glucose - drug effects - metabolism
Cross-Sectional Studies
Diabetes Mellitus, Type 1 - blood - diagnosis - drug therapy - epidemiology
Diabetes Mellitus, Type 2 - blood - diagnosis - drug therapy - epidemiology
Female
Guideline Adherence - standards
Health Services for the Aged - standards
Hemoglobin A, Glycosylated - metabolism
Home Care Services
Homes for the Aged
Humans
Hypoglycemic Agents - adverse effects - therapeutic use
Independent living
Male
Nursing Homes
Practice Guidelines as Topic - standards
Practice Patterns, Physicians' - standards
Prevalence
Process Assessment (Health Care) - standards
Quality Indicators, Health Care - standards
Sweden - epidemiology
Treatment Outcome
Abstract
To compare adherence to Swedish guidelines for diabetes care between elderly people living at home with or without home health care, and residents of nursing homes.
Medical records of 277 elderly people aged 80 and older, with known diabetes in a Swedish municipality, were monitored using quality indicators to evaluate processes and outcomes.
Monitoring, in accordance to diabetes guidelines, of HbA1c, lipids, blood pressure and foot examinations was lower among residents of nursing homes (p
PubMed ID
25865853 View in PubMed
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Are CSN and NKF-K/DOQI mineral metabolism guidelines for hemodialysis patients achievable? Results from a provincial renal program.

https://arctichealth.org/en/permalink/ahliterature155898
Source
CANNT J. 2008 Apr-Jun;18(2):36-41, 44-50; quiz 42-3, 51-2
Publication Type
Article
Author
Lori D Wazny
Colette B Raymond
Esther M Lesperance
Keevin N Bernstein
Author Affiliation
Department of Pharmaceutical Services, Health Sciences Centre, Winnipeg, MB. Lwazny@hsc.mb.ca
Source
CANNT J. 2008 Apr-Jun;18(2):36-41, 44-50; quiz 42-3, 51-2
Language
English
French
Publication Type
Article
Keywords
Aged
Calcium - blood
Cross-Sectional Studies
Drug Utilization
Female
Guideline Adherence - standards
Hemodialysis Solutions - therapeutic use
Humans
Kidney Failure, Chronic - etiology - metabolism - therapy
Male
Manitoba
Medical Audit
Middle Aged
Monitoring, Physiologic
Outcome Assessment (Health Care)
Parathyroid Hormone - blood
Phosphorus - blood
Practice Guidelines as Topic
Quality Indicators, Health Care
Renal Dialysis - methods - standards
Serum Albumin - metabolism
Treatment Outcome
Abstract
The calcium, phosphorus, and parathyroid hormone targets recommended by the Canadian Society of Nephrology (CSN) encompass a wider range of values as compared to the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (NKF-K/DOQI) guidelines. We sought to compare mineral metabolism parameters within the Manitoba Renal Program (MRP) to the CSN and NKF-K/DOQI guidelines. Medication use was also examined.
All hemodialysis patients in Manitoba were evaluated. Values for serum albumin, phosphorus, calcium, intact parathyroid hormone (PTH) and pertinent medications were collected.
Five hundred and forty-six patients were included in the analysis. Fifty-three per cent to 81% of MRP patients met individual CSN targets. However, only 26% of patients achieved all targets, despite high usage of phosphate (85.5% calcium carbonate, 16.1% sevelamer, 1.3% aluminum) and PTH-lowering drug therapies (30.2% calcitriol, 2.7% cinacalcet).
Only a small proportion of patients were able to achieve all three CSN mineral metabolism targets simultaneously. The majority of outliers presented with hyperphosphatemia or hypoparathyroidism.
PubMed ID
18669010 View in PubMed
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Assessment and documentation of patients' nutritional status: perceptions of registered nurses and their chief nurses.

https://arctichealth.org/en/permalink/ahliterature93100
Source
J Clin Nurs. 2008 Aug;17(16):2125-36
Publication Type
Article
Date
Aug-2008
Author
Persenius Mona Wentzel
Hall-Lord Marie-Louise
Bååth Carina
Larsson Bodil Wilde
Author Affiliation
Department of Nursing, Karlstad University, Karlstad, Sweden. mona.persenius@kau.se
Source
J Clin Nurs. 2008 Aug;17(16):2125-36
Date
Aug-2008
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Chi-Square Distribution
Documentation - standards
Guideline Adherence - standards
Health Knowledge, Attitudes, Practice
Humans
Logistic Models
Malnutrition - diagnosis - epidemiology
Mass Screening
Middle Aged
Models, Nursing
Nurse Administrators - psychology
Nurse's Role
Nursing Assessment - standards
Nursing Evaluation Research
Nursing Methodology Research
Nursing Records - standards
Nursing Staff - education - organization & administration - psychology
Nutrition Assessment
Nutritional Status
Practice Guidelines as Topic
Questionnaires
Statistics, nonparametric
Sweden - epidemiology
Abstract
AIMS: To study, within municipal care and county council care, (1) chief nurses' and registered nurses' perceptions of patient nutritional status assessment and nutritional assessment/screening tools, (2) registered nurses' perceptions of documentation in relation to nutrition and advantages and disadvantages with a documentation model. BACKGROUND: Chief nurses and registered nurses have a responsibility to identify malnourished patients and those at risk of malnutrition. DESIGN AND METHODS: In this descriptive study, 15 chief nurses in municipal care and 27 chief nurses in county council care were interviewed by telephone via a semi-structured interview guide. One hundred and thirty-one registered nurses (response rate 72%) from 14 municipalities and 28 hospital wards responded to the questionnaire, all in one county. RESULTS: According to the majority of chief nurses and registered nurses, only certain patients were assessed, on admission and/or during the stay. Nutritional assessment/screening tools and nutritional guidelines were seldom used. Most of the registered nurses documented nausea/vomiting, ability to eat and drink, diarrhoea and difficulties in chewing and swallowing, while energy intake and body mass index were rarely documented. However, the majority documented their judgement about the patient's nutritional condition. The registered nurses perceived the VIPS model (Swedish nursing documentation model) as a guideline as well as a model obstructing the information exchange. Differences were found between nurses (chief nurses/registered nurses) in municipal care and county council care, but not between registered nurses and their chief nurses. CONCLUSIONS: All patients are not nutritionally assessed and important nutritional parameters are not documented. Nutritionally compromised patients may remain unidentified and not properly cared for. RELEVANCE TO CLINICAL PRACTICE: Assessment and documentation of the patients' nutritional status should be routinely performed in a more structured way in both municipal care and county council care. There is a need for increased nutritional nursing knowledge.
PubMed ID
18510576 View in PubMed
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Barriers and facilitators for guideline adherence in diagnostic imaging: an explorative study of GPs' and radiologists' perspectives.

https://arctichealth.org/en/permalink/ahliterature298054
Source
BMC Health Serv Res. 2018 07 16; 18(1):556
Publication Type
Journal Article
Date
07-16-2018
Author
Ann Mari Gransjøen
Siri Wiig
Kristin Bakke Lysdahl
Bjørn Morten Hofmann
Author Affiliation
Department of Health sciences in Gjøvik, Norwegian University of Science and Technology in Gjøvik (NTNU), Teknologiveien 22, 2815, Gjøvik, Norway. ann.gransjoen@ntnu.no.
Source
BMC Health Serv Res. 2018 07 16; 18(1):556
Date
07-16-2018
Language
English
Publication Type
Journal Article
Keywords
Adult
Attitude of Health Personnel
Diagnostic Imaging - standards
Female
General Practitioners - standards
Guideline Adherence - standards
Humans
Male
Middle Aged
Norway
Perception
Practice Guidelines as Topic - standards
Practice Patterns, Physicians' - standards
Radiologists - standards
Abstract
Diagnostic imaging has been a part of medicine for the last century. It has been difficult to implement guidelines in this field, and unwarranted imaging has been a frequent problem. Some work has been done to explain these phenomena separately. Identifying the barriers to and facilitators of guideline use has been one strategy. The aim of this study is to offer a more comprehensive explanation of deviations from the guideline by studying the two phenomena together.
Eight general practitioners and 10 radiologists from two counties in Norway agreed to semi-structured interviews. Topics covered in the interviews were knowledge of the guideline, barriers to and facilitators of guideline use, implementation of guidelines and factors that influence unwarranted imaging.
Several barriers to and facilitators of guideline use were identified. Among these are lack of time, pressure from patients, and guidelines being too long, rigid or unclear. Facilitators of guideline use were easy accessibility and having the guidelines adapted to the target group. Some of the factors that influence unwarranted imaging are lack of time, pressure from patients and availability of imaging services.
There are similarities between the perceived barriers for guideline adherence and the perceived factors that influence unwarranted imaging. There may be a few reasons that explains the deviation from guidelines, and the amount of unwarranted imaging.
PubMed ID
30012130 View in PubMed
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Barriers to effective implementation of guideline recommendations.

https://arctichealth.org/en/permalink/ahliterature171502
Source
Am J Med. 2005 Dec;118 Suppl 12A:36-41
Publication Type
Article
Date
Dec-2005
Author
Leif R Erhardt
Author Affiliation
Department of Cardiology, University of Lund at Malmö University Hospital, Malmö, Sweden. Leif.erhardt@medforsk.mas.lu.se
Source
Am J Med. 2005 Dec;118 Suppl 12A:36-41
Date
Dec-2005
Language
English
Publication Type
Article
Keywords
Cardiovascular Diseases - drug therapy - prevention & control
Guideline Adherence - standards
Health Planning Guidelines
Humans
Ontario
Patient Education as Topic - methods - standards
Practice Guidelines as Topic - standards
Risk factors
Abstract
Cardiovascular disease (CVD) is the leading cause of death worldwide, and its prevention and treatment are important healthcare aims. Hypercholesterolemia is among the most important modifiable risk factors for CVD, and numerous guidelines exist for the treatment of this condition. Nevertheless, despite the existence of well-established and safe pharmacologic therapy for lowering cholesterol and preventing CVD, surveys in the United States and Europe have revealed that many patients have elevated cholesterol levels. There is a clear gap between what is known about treating CVD and the implementation of that knowledge. A survey assessing patients' knowledge about CVD observed that many patients are unaware of the disease prevalence and have little knowledge about the main risk factors, including the importance of cholesterol. Another survey demonstrated that many physicians overestimate patients' awareness of CVD and that physicians also overestimate the extent to which guidelines are implemented in clinical practice. Guideline implementation may be improved by narrowing the discrepancies between what patients and physicians believe and the reality. Many physicians claim that lack of time hinders guideline implementation and improvement of patient education. Physicians also appear to lack the motivation to implement lipid-lowering interventions. A multifactorial approach to improving use of guidelines in clinical practice may improve the treatment and prevention of CVD.
PubMed ID
16356806 View in PubMed
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Benefits of Water Safety Plans: microbiology, compliance, and public health.

https://arctichealth.org/en/permalink/ahliterature123644
Source
Environ Sci Technol. 2012 Jul 17;46(14):7782-9
Publication Type
Article
Date
Jul-17-2012
Author
Maria J Gunnarsdottir
Sigurdur M Gardarsson
Mark Elliott
Gudrun Sigmundsdottir
Jamie Bartram
Author Affiliation
Faculty of Civil and Environmental Engineering, University of Iceland, Hjardarhaga 2-6, 107 Reykjavik, Iceland. mariag@hi.is
Source
Environ Sci Technol. 2012 Jul 17;46(14):7782-9
Date
Jul-17-2012
Language
English
Publication Type
Article
Keywords
Colony Count, Microbial
Diarrhea - epidemiology
Drinking Water - microbiology - standards
Guideline Adherence - standards
Heterotrophic Processes
Humans
Iceland - epidemiology
Incidence
Logistic Models
Public Health - legislation & jurisprudence - standards
Safety - legislation & jurisprudence
Social Control, Formal
Water Microbiology - standards
Water Quality - standards
Water Supply - legislation & jurisprudence
Abstract
The Water Safety Plan (WSP) methodology, which aims to enhance safety of drinking water supplies, has been recommended by the World Health Organization since 2004. WSPs are now used worldwide and are legally required in several countries. However, there is limited systematic evidence available demonstrating the effectiveness of WSPs on water quality and health. Iceland was one of the first countries to legislate the use of WSPs, enabling the analysis of more than a decade of data on impact of WSP. The objective was to determine the impact of WSP implementation on regulatory compliance, microbiological water quality, and incidence of clinical cases of diarrhea. Surveillance data on water quality and diarrhea were collected and analyzed. The results show that HPC (heterotrophic plate counts), representing microbiological growth in the water supply system, decreased statistically significant with fewer incidents of HPC exceeding 10 cfu per mL in samples following WSP implementation and noncompliance was also significantly reduced (p
PubMed ID
22679926 View in PubMed
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Best practices in scleroderma: an analysis of practice variability in SSc centres within the Canadian Scleroderma Research Group (CSRG).

https://arctichealth.org/en/permalink/ahliterature122345
Source
Clin Exp Rheumatol. 2012 Mar-Apr;30(2 Suppl 71):S38-43
Publication Type
Article
Author
Sarah Harding
Sarit Khimdas
Ashley Bonner
Murray Baron
Janet Pope
Author Affiliation
University of Western Ontario, London, ON, Canada. sarahharding@rcsi.ie
Source
Clin Exp Rheumatol. 2012 Mar-Apr;30(2 Suppl 71):S38-43
Language
English
Publication Type
Article
Keywords
Benchmarking - standards
Canada
Consensus
Databases, Factual
Diagnostic Tests, Routine - standards
Evidence-Based Medicine - standards
Female
Guideline Adherence - standards
Humans
Male
Middle Aged
Outcome and Process Assessment (Health Care) - standards
Physician's Practice Patterns - standards
Practice Guidelines as Topic - standards
Predictive value of tests
Prospective Studies
Quality Indicators, Health Care - standards
Rheumatology - standards
Scleroderma, Systemic - complications - diagnosis - therapy
Severity of Illness Index
Time Factors
Treatment Outcome
Abstract
There is currently no consensus on best practice in systemic sclerosis (SSc). To determine if variability in treatment and investigations exists, practices among Canadian Sclerodermia Research Group (CSRG) centres were compared.
Prospective clinical and demographic data from adult SSc patients are collected annually from 15 CSRG treatment centres. Laboratory parameters, self-reported socio-demographic questionnaires, current and past medications and disease outcome measures are recorded. For centres with >50 patients enrolled, treatment practices were analysed to determine practice variability.
Data from 640 of 938 patients within the CSRG database met inclusion criteria, where 87.3% were female, the mean ± SEM age was 55.3±0.5, 48.9% had limited SSc and 47.8% had diffuse SSc (and 3.3% uncharacterised). Some investigation and treatment practices were inconsistent among 6 centres including proportion receiving: PDE5 (phosphodiesterase type 5) inhibitors for Raynaud's phenomenon (p=0.036); cyclophosphamide (p=0.037) and azathioprine (p=0.037) for treatment of ILD; and current use of D-penicillamine, although uncommon, varied among sites. Annual echocardiograms and PFTs were frequently done and did not vary among sites but the rate of pulmonary arterial hypertension (PAH) was directly related to site size and this was not the case for other organ involvement.
Despite routine tests within a database, site variation in SSc with respect to investigations and management among CSRG centres exists suggesting a need for a standardised approach to the investigation and treatment of SSc. One can speculate that larger centres are more export in detecting PAH.
PubMed ID
22691207 View in PubMed
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100 records – page 1 of 10.