Physicians often fail to deliver four standard basics of follow-up cardiac care, according to a study reported Sunday at the American Heart Association scientific meeting in Orlando, Fla.
For example, 31% of heart failure patients who are ideal candidates for ACE inhibitors are discharged without this proven therapy, the researchers find.
Their assessment of adherence to three other quality-of-care indicators for heart care shows some doctors and hospitals clearly lagging.
"There is marked variation and a lack of structure in cardiovascular care in the nation's hospitals," says lead investigator Gregg Fonarrow, M.D., in a written statement. "There is a lot more that can be done before heart failure patients leave the hospital to improve the quality of patients' lives and make sure they continue to do well."
According to the study, 72% of cardiac patients were discharged without receiving a complete set of discharge instructions, including medication and dietary information, a follow-up appointment, signs to looks for and actions to take if there are problems.
The researchers also found left ventricular function, which determines the pumping capability of the heart, was not assessed in 18% of patients, and 69% of current or recent smokers were not counseled on quitting.
The study examined 33,046 of about 100,000 patients enrolled in the Acute Decompensated Heart Failure National Registry, or ADHERE, which includes data from 250 participating hospitals.
"These standards exist because they have been proven to benefit patients by increasing survival and reducing the risk of rehospitalization," says Fonarrow, chair of cardiovascular medicine and science at the University of California at Los Angeles. "If hospitals improved their adherence to the guidelines, it would have a huge impact on the lives of heart-failure patients."