Top Things to Know: Take-Home Messages for Update of Adults With Heart Failure
Published: August 08, 2024
- This document describes performance measures for heart failure that are appropriate for public reporting or pay-for-performance programs (ie, a form of value-based purchasing).
- The performance measures are taken from the “2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines” and are selected from the strongest recommendations (Class 1 or 3).
- Quality measures are also provided that are not yet ready for public reporting or pay-for-performance but might be useful for clinicians and healthcare organizations for quality improvement.
- For all measures, if the clinician determines the care is not appropriate for the patient based on objective evidence to support decision-making, or if the patient declines treatment, that patient is excluded from the measure.
- For all measures, patients after heart transplantation or left ventricular assist device placement are excluded.
- Blood pressure control in heart failure with preserved ejection fraction is added as a performance measure.
- The use of sodium-glucose cotransporter-2 inhibitors for patients with heart failure across the spectrum of ejection fraction is added as a performance measure for heart failure with reduced ejection fraction and as a quality measure for heart failure with mildly reduced and preserved ejection fraction.
- To address the importance of optimization of heart failure medications, a performance measure is added for the initiation of optimal guideline-directed medical therapy in hospitalized patients, and quality measures are added for the optimization of guideline-directed medical therapy prior to intervention for chronic secondary severe mitral regurgitation and for continuation of guideline-directed medical therapy for patients with heart failure with improved ejection fraction.
- Highlighting the importance of multidisciplinary care, quality measures are added to emphasize targeting both known risks for cardiovascular disease and social determinants of health and patient-centered counseling regarding contraception and pregnancy risks for individuals with cardiomyopathy.
- To reflect the importance of accurate diagnosis of cardiac amyloidosis, a performance measure is added for a monoclonal protein screen to exclude light chain amyloidosis when interpreting a bone scintigraphy scan assessing for transthyretin cardiac amyloidosis.
Citation
Kittleson MM, Breathett K, Ziaeian B, Aguilar D, Blumer V, Bozkurt B, Diekemper RL, Dorsch MP, Heidenreich PA, Jurgens CY, Khazanie P, Koromia GA, Van Spall HGC. 2024 Update to the 2020 ACC/AHA clinical performance andquality measures for adults with heart failure: a report of the American Heart Association/American College ofCardiology Joint Committee on Performance Measures. Circ Cardiovasc Qual Outcomes. Published online August 8, 2024. doi: 10.1161/HCQ.0000000000000132