Facilitated Data Relay and Effects on Treatment of Severe Aortic Stenosis in Europe

Background-Many patients with severe aortic stenosis are referred late with advanced symptoms or inappropriately denied intervention. The objective was to investigate whether a structured communication to referring physicians (facilitated data relay) might improve the rate and timeliness of interven...

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Autores: Steeds, RP, Lutz, M, Thambyrajah, J, Serra, A, Schulz, E, Maly, J, Aiello, M, Rudolph, TK, Lloyd, G, Santo Bortone, A, Hauptmann, KE, Clerici, A, Delle-Karth, G, Rieber, J, Indolfi, C, Mancone, M, Belle, L, Lauten, A, Arnold, M, Bouma, BJ, Deutsch, C, Kurucova, J, Thoenes, M, Bramlage, P, Frey, N, Messika-Zeitoun, D
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p2408
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=2408
Access Level:acceso abierto
Palabra clave:Quality of care
aortic stenosis
transcatheter aortic valve implantation
surgical aortic valve replacement
facilitated data relay
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spelling Facilitated Data Relay and Effects on Treatment of Severe Aortic Stenosis in EuropeSteeds, RPLutz, MThambyrajah, JSerra, ASchulz, EMaly, JAiello, MRudolph, TKLloyd, GSanto Bortone, AHauptmann, KEClerici, ADelle-Karth, GRieber, JIndolfi, CMancone, MBelle, LLauten, AArnold, MBouma, BJDeutsch, CKurucova, JThoenes, MBramlage, PFrey, NMessika-Zeitoun, DQuality of careaortic stenosistranscatheter aortic valve implantationsurgical aortic valve replacementfacilitated data relayBackground-Many patients with severe aortic stenosis are referred late with advanced symptoms or inappropriately denied intervention. The objective was to investigate whether a structured communication to referring physicians (facilitated data relay) might improve the rate and timeliness of intervention. Methods and Results-A prospective registry of consecutive patients with severe aortic stenosis at 23 centers in 9 European countries with transcatheter as well as surgical aortic valve replacement being available was performed. The study included a 3-month documentation of the status quo (phase A), a 6-month intervention phase (implementing facilitated data relay), and a 3-month documentation of a legacy effect (phase-B). Two thousand one hundred seventy-one patients with severe aortic stenoses were enrolled (phase A: 759; intervention: 905; phase-B: 507). Mean age was 77.9 +/- 10.0 years, and 80% were symptomatic, including 52% with severe symptoms. During phase A, intervention was planned in 464/696 (67%), 138 (20%) were assigned to watchful waiting, 8 (1%) to balloon aortic valvuloplasty, 60 (9%) were listed as not for active treatment, and in 26 (4%), no decision was made. Three hundred sixty-three of 464 (78%) patients received the planned intervention within 3 months. Timeliness of the intervention improved as shown by the higher number of aortic valve replacements performed within 3 months (59% versus 51%, P=0.002) and a significant decrease in the time to intervention (36 +/- 38 versus 30 +/- 33 days, P=0.002). Conclusions-A simple, low-cost, facilitated data relay improves timeliness of treatment for patients diagnosed with severe aortic stenosis, resulting in a shorter time to transcatheter aortic valve replacement. This effect was mainly driven by a significant improvement in timeliness of intervention in transcatheter aortic valve replacement but not surgical aortic valve replacement. Clinical Trial Registration-URL: https://www.clinicaltrials.gov/. Unique identifier: NCT02241447.WILEY2019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=2408Journal of the American Heart AssociationISSN: 20479980reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p24082026-06-14T12:41:47Z
dc.title.none.fl_str_mv Facilitated Data Relay and Effects on Treatment of Severe Aortic Stenosis in Europe
title Facilitated Data Relay and Effects on Treatment of Severe Aortic Stenosis in Europe
spellingShingle Facilitated Data Relay and Effects on Treatment of Severe Aortic Stenosis in Europe
Steeds, RP
Quality of care
aortic stenosis
transcatheter aortic valve implantation
surgical aortic valve replacement
facilitated data relay
title_short Facilitated Data Relay and Effects on Treatment of Severe Aortic Stenosis in Europe
title_full Facilitated Data Relay and Effects on Treatment of Severe Aortic Stenosis in Europe
title_fullStr Facilitated Data Relay and Effects on Treatment of Severe Aortic Stenosis in Europe
title_full_unstemmed Facilitated Data Relay and Effects on Treatment of Severe Aortic Stenosis in Europe
title_sort Facilitated Data Relay and Effects on Treatment of Severe Aortic Stenosis in Europe
dc.creator.none.fl_str_mv Steeds, RP
Lutz, M
Thambyrajah, J
Serra, A
Schulz, E
Maly, J
Aiello, M
Rudolph, TK
Lloyd, G
Santo Bortone, A
Hauptmann, KE
Clerici, A
Delle-Karth, G
Rieber, J
Indolfi, C
Mancone, M
Belle, L
Lauten, A
Arnold, M
Bouma, BJ
Deutsch, C
Kurucova, J
Thoenes, M
Bramlage, P
Frey, N
Messika-Zeitoun, D
author Steeds, RP
author_facet Steeds, RP
Lutz, M
Thambyrajah, J
Serra, A
Schulz, E
Maly, J
Aiello, M
Rudolph, TK
Lloyd, G
Santo Bortone, A
Hauptmann, KE
Clerici, A
Delle-Karth, G
Rieber, J
Indolfi, C
Mancone, M
Belle, L
Lauten, A
Arnold, M
Bouma, BJ
Deutsch, C
Kurucova, J
Thoenes, M
Bramlage, P
Frey, N
Messika-Zeitoun, D
author_role author
author2 Lutz, M
Thambyrajah, J
Serra, A
Schulz, E
Maly, J
Aiello, M
Rudolph, TK
Lloyd, G
Santo Bortone, A
Hauptmann, KE
Clerici, A
Delle-Karth, G
Rieber, J
Indolfi, C
Mancone, M
Belle, L
Lauten, A
Arnold, M
Bouma, BJ
Deutsch, C
Kurucova, J
Thoenes, M
Bramlage, P
Frey, N
Messika-Zeitoun, D
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Quality of care
aortic stenosis
transcatheter aortic valve implantation
surgical aortic valve replacement
facilitated data relay
topic Quality of care
aortic stenosis
transcatheter aortic valve implantation
surgical aortic valve replacement
facilitated data relay
description Background-Many patients with severe aortic stenosis are referred late with advanced symptoms or inappropriately denied intervention. The objective was to investigate whether a structured communication to referring physicians (facilitated data relay) might improve the rate and timeliness of intervention. Methods and Results-A prospective registry of consecutive patients with severe aortic stenosis at 23 centers in 9 European countries with transcatheter as well as surgical aortic valve replacement being available was performed. The study included a 3-month documentation of the status quo (phase A), a 6-month intervention phase (implementing facilitated data relay), and a 3-month documentation of a legacy effect (phase-B). Two thousand one hundred seventy-one patients with severe aortic stenoses were enrolled (phase A: 759; intervention: 905; phase-B: 507). Mean age was 77.9 +/- 10.0 years, and 80% were symptomatic, including 52% with severe symptoms. During phase A, intervention was planned in 464/696 (67%), 138 (20%) were assigned to watchful waiting, 8 (1%) to balloon aortic valvuloplasty, 60 (9%) were listed as not for active treatment, and in 26 (4%), no decision was made. Three hundred sixty-three of 464 (78%) patients received the planned intervention within 3 months. Timeliness of the intervention improved as shown by the higher number of aortic valve replacements performed within 3 months (59% versus 51%, P=0.002) and a significant decrease in the time to intervention (36 +/- 38 versus 30 +/- 33 days, P=0.002). Conclusions-A simple, low-cost, facilitated data relay improves timeliness of treatment for patients diagnosed with severe aortic stenosis, resulting in a shorter time to transcatheter aortic valve replacement. This effect was mainly driven by a significant improvement in timeliness of intervention in transcatheter aortic valve replacement but not surgical aortic valve replacement. Clinical Trial Registration-URL: https://www.clinicaltrials.gov/. Unique identifier: NCT02241447.
publishDate 2019
dc.date.none.fl_str_mv 2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=2408
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=2408
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv WILEY
publisher.none.fl_str_mv WILEY
dc.source.none.fl_str_mv Journal of the American Heart Association
ISSN: 20479980
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
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