Impact of cardiology referral: clinical outcomes and factors associated with physicians' adherence to recommendations
Clinics
; 69(10): 666-671, 10/2014. tab, graf
Artigo
em Inglês
| LILACS
| ID: lil-730466
Biblioteca responsável:
BR1.1
ABSTRACT
OBJECTIVES:
Cardiology referral is common for patients admitted for non-cardiac diseases. Recommendations from cardiologists may involve complex and aggressive treatments that could be ignored or denied by other physicians. The purpose of this study was to compare the outcomes of patients who were given recommendations during cardiology referrals and to examine the clinical outcomes of patients who did not follow the recommendations.METHODS:
We enrolled 589 consecutive patients who received in-hospital cardiology consultations. Data on recommendations, implementation of suggestions and outcomes were collected.RESULTS:
Regarding adherence of the referring service to the recommendations, 77% of patients were classified in the adherence group and 23% were classified in the non-adherence group. Membership in the non-adherence group (p<0.001; odds ratio 10.25; 95% CI 4.45-23.62) and advanced age (p = 0.017; OR 1.04; 95% CI 1.01-1.07) were associated with unfavorable outcomes. Multivariate analysis identified four independent predictors of adherence torecommendations:
follow-up notes in the medical chart (p<0.001; OR 2.43; 95% CI 1.48-4.01); verbal reinforcement (p = 0.001; OR 1.86; 95% CI 1.23-2.81); a small number of recommendation (p = 0.001; OR 0.87; 95% CI 0.80-0.94); and a younger patient age (p = 0.002; OR 0.98; 95% CI 0.96-0.99).CONCLUSIONS:
Poor adherence to cardiology referral recommendations was associated with unfavorable clinical outcomes. Follow-up notes in the medical chart, verbal reinforcement, a limited number of recommendations and a patient age were associated with greater adherence to recommendations. .
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Base de dados:
LILACS
Assunto principal:
Encaminhamento e Consulta
/
Cardiologia
/
Fidelidade a Diretrizes
Tipo de estudo:
Estudo de etiologia
/
Guia de prática clínica
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Idoso
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Clinics
Assunto da revista:
Medicina
Ano de publicação:
2014
Tipo de documento:
Artigo
/
Documento de projeto
País de afiliação:
Brasil
Instituição/País de afiliação:
Instituto do Coração (INCOR) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo/BR