Good Measures Improve Clinical Care - Feature Story 

The story of how beta-blockers came to be prescribed for heart attack patients began more than 32 years ago, with the publication of the Beta-Blocker Heart Attack Trial in 1982 in the Journal of the American Medical Association. The study detailed the results of a randomized trial that curtailed nine months early because mortality rates were so clearly lower for heart attack patients receiving beta-blockers (7.2 percent vs. 9.8 percent) than patients in the control group.

Clinical guidelines recommending the use of beta-blockers followed, as did related quality measures – first from the National Committee for Quality Assurance (NCQA) and then from other organizations. NQF initially endorsed the Centers for Medicare and Medicaid Services measure 0160, beta-blocker prescribed at discharge for acute myocardial infarction (AMI), in 2007. Five years later, the use of beta-blockers was so profoundly positive for patients and so widely adopted in clinical practice that NQF retired the measure, giving it “reserve status,” a special designation for measures that have been widely adopted in clinical practice because of their profoundly positive impact.

“The use of beta blockers among patients who have suffered heart attacks stands as one of the early victories of the quality movement and has benefited hundreds of thousands of people,” said Margaret O’Kane, President of the National Committee for Quality Assurance. “Quality measurement was an essential tool that helped drive this clinical change, and is vital to future advances in care.”