Special ArticlePractice gaps in the care of mitral valve regurgitation: Insights from the American College of Cardiology mitral regurgitation gap analysis and advisory panel
Section snippets
Background
Mitral regurgitation (MR) is one of the most common valvular lesions. Contemporary treatment options include medical therapy, surgical mitral valve repair or replacement, and recently, percutaneous mitral valve repair. Guidelines on the evaluation and treatment for patients with valvular heart disease (VHD) are important consensus documents that help to standardize and optimize MR care.1, 2 Previous survey-based studies indicate that MR is often undertreated and that practice patterns are often
Phase 1: Literature review
Between June and August 2013, the ACC Education Needs Assessment and Research group compiled and analyzed the published literature as well as existing ACC data sources to characterize knowledge, practice gaps, and potential barriers to optimal practice. The findings from this initial effort informed the subsequent phases of the project.
Phase 2: Physician interviews
The ACC Education Needs Assessment and Research group gathered and analyzed qualitative data via interviews with 16 practicing US cardiologists and
Sample characteristics
A total of 297 US physicians responded to the set of 3 surveys, including 89 respondents to the primary care survey, 105 respondents for the general cardiologist survey, and 103 respondents for the cardiovascular subspecialist survey. Demographic characteristics of respondents for each survey are shown in Table I.
Perceived barriers to MR care
From a broad perspective, perceived, significant barriers to providing optimal care for the patient with MR are shown in Table II. Only 23.6%, 41.9%, and 41.7% of respondents to the
Discussion
Based on the compilation of data analysis, interviews, surveys, and advisory panel meeting led by the ACC Education Needs Assessment and Research group, several high-priority practice gaps were identified. For each practice gap, the expert advisory panel has outlined educational needs aligned with recommendations from the 2014 AHA/ACC valvular disease guidelines2 and proposals to improve the care of patients with MR (Table VI).
Acknowledgment
This needs assessment and gap analysis was supported by a grant from Abbott Vascular.
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