European Society of Cardiology Quality Indicators for Cardiovascular Disease Prevention: developed by the Working Group for Cardiovascular Disease Prevention Quality Indicators in collaboration with the European Association for Preventive Cardiology of the European Society of Cardiology

Suleman Aktaa; Baris Gencer; Elena Arbelo; Constantinos H Davos; Ileana Désormais; Monika Hollander; Ana Abreu; Marco Ambrosetti; Maria Bäck; David Carballo; Carolyn Crawford; Christi Deaton; Paul Dendale; Thijs M H Eijsvogels; Mary Galbraith; Massimo Francesco Piepoli; Annett Salzwedel; Yvo Smulders; Matthias Wilhelm; Giuseppe Biondi-Zoccai; François Mach; Frank L J Visseren; Chris P Gale

doi:10.1093/eurjpc/zwab160

European Society of Cardiology Quality Indicators for Cardiovascular Disease Prevention: developed by the Working Group for Cardiovascular Disease Prevention Quality Indicators in collaboration with the European Association for Preventive Cardiology of the European Society of Cardiology

Eur J Prev Cardiol. 2022 May 25;29(7):1060-1071. doi: 10.1093/eurjpc/zwab160.

Authors

Suleman Aktaa^{1

2

3}, Baris Gencer^{4

5}, Elena Arbelo^{6

7

8}, Constantinos H Davos⁹, Ileana Désormais¹⁰, Monika Hollander¹¹, Ana Abreu¹², Marco Ambrosetti¹³, Maria Bäck^{14

15}, David Carballo¹⁶, Carolyn Crawford¹⁷, Christi Deaton¹⁸, Paul Dendale¹⁹, Thijs M H Eijsvogels²⁰, Mary Galbraith¹⁷, Massimo Francesco Piepoli²¹, Annett Salzwedel²², Yvo Smulders²³, Matthias Wilhelm²⁴, Giuseppe Biondi-Zoccai^{25

26}, François Mach⁴, Frank L J Visseren²⁷, Chris P Gale^{1

2

3}

Affiliations

¹ Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9LU, UK.
² Leeds Institute for Data Analytics, University of Leeds, Leeds LS2 9LU, UK.
³ Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
⁴ Division of Cardiology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland.
⁵ Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
⁶ Arrhythmia Section, Cardiology Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
⁷ IDIBAPS, Institut d'Investigació August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
⁸ Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.
⁹ Cardiovascular Research Laboratory, Biomedical Research Foundation, Academy of Athens, Athens, Greece.
¹⁰ Department of Thoracic and Cardiovascular Surgery and Angiology, Dupuytren University Hospital, Limoges, France.
¹¹ Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, Utrecht 3584 CG, The Netherlands.
¹² Cardiology Department, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, (CHULN) Lisboa, Lisbon, Portugal.
¹³ Cardiovascular Rehabilitation Unit, ASST Crema, Rivolta D'Adda Hospital, Rivolta D' Adda, Italy.
¹⁴ Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
¹⁵ Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden.
¹⁶ Department of Cardiology, Cardiovascular Center, University Hospital Geneva, Rue Gabrielle-Perret-Gentil 4, Geneva 1205, Switzerland.
¹⁷ ESC Patient Forum, Sophia Antipolis, France.
¹⁸ Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Forvie Site, Cambridge Biomedical Campus, Cambridge CB22 5DT, UK.
¹⁹ Heart Centre Hasselt and Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
²⁰ Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
²¹ Heart Failure Unit, Cardiology, Guglielmo da Saliceto Hospital, and University pof Parma, Piacenza, Italy.
²² Department of Rehabilitation Medicine, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany.
²³ Department of Internal Medicine and Geriatrics, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands.
²⁴ Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
²⁵ Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.
²⁶ Mediterranea Cardiocentro, Napoli, Italy.
²⁷ Department of Vascular Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, Utrecht, The Netherlands.

PMID: 34687540
DOI: 10.1093/eurjpc/zwab160

Abstract

Aims: To develop a set of quality indicators (QIs) for the evaluation of the care and outcomes for atherosclerotic cardiovascular disease (ASCVD) prevention.

Methods and results: The Quality Indicator Committee of the European Society of Cardiology (ESC) formed the Working Group for Cardiovascular Disease Prevention Quality Indicators in collaboration with Task Force members of the 2021 ESC Guidelines on Cardiovascular Disease Prevention in Clinical Practice and the European Association of Preventive Cardiology (EAPC). We followed the ESC methodology for QI development, which involved (i) the identification of the key domains of care for ASCVD prevention by constructing a conceptual framework of care, (ii) the development of candidate QIs by conducting a systematic review of the literature, (iii) the selection of the final set of QIs using a modified Delphi method, and (iv) the evaluation of the feasibility of the developed QIs. In total, 17 main and 14 secondary QIs were selected across six domains of care for ASCVD prevention: (i) structural framework, (ii) risk assessment, (iii) care for people at risk for ASCVD, (iv) care for patients with established ASCVD, (v) patient education and experience, and (vi) outcomes.

Conclusion: We present the 2021 ESC QIs for Cardiovascular Disease Prevention, which have been co-constructed with EAPC using the ESC methodology for QI development. These indicators are supported by evidence from the literature, underpinned by expert consensus and aligned with the 2021 ESC Guidelines on Cardiovascular Disease Prevention in Clinical Practice to offer a mechanism for the evaluation of ASCVD prevention care and outcomes.

Keywords: Cardiovascular disease; Atherosclerosis; Clinical practice guidelines; Preventive cardiology; Quality indicators.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Advisory Committees
Atherosclerosis*
Cardiology*
Cardiovascular Diseases* / diagnosis
Cardiovascular Diseases* / prevention & control
Humans
Quality Indicators, Health Care
Risk Assessment