Effectiveness of Data-Driven Quality Improvement on Hospitalizations and Health Outcomes for People With Coronary Heart Disease in Primary Care (QUEL): A Cluster Randomized Controlled Trial With 24-Month Follow-Up

作者：Julie Redfern, Nashid Hafiz, Qiang Tu, Andrew Knight, C. Hespe, C. Chow, Tom Briffa, Robyn Gallagher, Christopher M. Reid, David L. Hare, Deborah Manandi, Nicholas Zwar, Mark Woodward, S Jan, Emily Atkins, Tracey‐Lea Laba, Elizabeth Halcomb, Laurent Billot, Tim Usherwood, Karice Hyun · 发表于：Circulation Population Health and Outcomes · 年份：2026 · DOI：10.1161/circoutcomes.125.012904 · 被引用次数：1 · 研究领域：Primary Care and Health Outcomes、Chronic Disease Management Strategies、Health Policy Implementation Science

BACKGROUND: This trial aimed to test the effectiveness of a data-driven quality improvement program in primary care on cardiovascular hospitalizations, major adverse cardiovascular events (MACE), risk factor profiles, and medication prescriptions at 24 months in people with coronary heart disease (CHD) compared with standard care. METHODS: A single-blind, cluster randomized controlled trial recruiting Australian primary care practices (2019-2022) was conducted. Practices using compliant data extraction software and having ≥200 adult patients annually with CHD were the units of randomization, and adults with CHD (who visited their general practitioner in the past 12 months) were the units of analysis. Practices were randomized to intervention (12-month data-driven quality improvement including benchmarking, monthly reporting, and improvement planning) or control (standard care). The primary outcome was the proportion of participants who had unplanned cardiovascular disease hospitalizations at 24 months. Secondary outcomes were MACE, medication prescriptions, risk factor targets, and management planning. Data were extracted from electronic records linked to administrative data. RESULTS: A total of 51 primary care practices participated, resulting in a patient cohort of 7864. The mean age of the patient cohort was 71.9 (±11.8) years, 68% were men, and 24% had a prior myocardial infarction. At 24 months, there was no significant difference between the groups for unplanned cardiov...