Effect of a Quality Improvement Intervention on Adherence to Therapies for Patients With Acute Ischemic Stroke and Transient Ischemic Attack: A Cluster Randomized Clinical Trial

摘要

Key PointsQuestionCan a multifaceted quality improvement intervention increase the adherence to 10 evidence-based performance measures for patients with acute ischemic stroke and transient ischemic attack in Latin America? FindingsIn this cluster randomized clinical trial that included 1624 patients from 36 hospitals in 3 countries, hospitals in the intervention group had a composite adherence score of 85.3% for the evidence-based performance measures, and those in the control group had a score of 77.8%, a difference that was not statistically significant. In a planned secondary analysis, improvement in adherence to all 10 performance measures was greater in the intervention group than in the control group using an all-or-none approach for the outcome. MeaningIn this cohort of patients with acute ischemic stroke and transient ischemic attack, a multifaceted intervention did not demonstrate an overall improvement in adherence to evidence-based performance measures compared with standard of care, yet individual care elements improved.