AHRQ Guide on Improving the Quality of Health Care

The Agency for Healthcare Research and Quality (AHRQ) has published a new booklet on what patients can do to improve the quality of the health care they receive. “Improving Health Care Quality: A Guide for Patients and Families” focuses on key health care decisions, such as choices about physicians, hospitals and treatments, and offers practical tips about how patients can avoid medical errors. The guide also stresses that patients should take an active role in all decisions about their own health care.

For patients who want to be actively involved in making decisions concerning their health care, the AHRQ guide makes the following recommendations:

• Patients must work together with physicians, nurses and other health care professionals to make decisions about their care.

• Patients should ask questions and keep asking until the answers are clear.

• Patients should tell their physician about all medications they are currently taking.

• When a radiograph or laboratory test is done, patients should ask when and how they will receive the results. They should never assume that “no news is good news.”

• If surgery is indicated, the physician, surgeon and patient should agree on what will be done.

• Patients should be aware that “more is not always better,” and should find out why a test or treatment is necessary and how it can help.

• When making health care decisions, patients should find and use information on quality measures.

Copies of the booklet are available free of charge by calling the AHRQ Publications Clearinghouse at 800-358-9295 (410-381-3150 for international calls), or by writing to the AHRQ Clearinghouse, P.O. Box 8547, Silver Spring, MD 20907. The guide is also available on the AHRQ Web site athttp://www.ahrq.gov/consumer/qntlite.

FDA Approves System for In-Stent Restenosis

The U.S. Food and Drug Administration (FDA) has approved the Checkmate Intravascular Brachytherapy System, the first intravascular brachytherapy system for recurrent blockages in coronary arteries that have been previously treated with coronary artery stents.

After placement of a coronary artery stent, the vessel wall sometimes responds by forming scar tissue that pushes through the openings in the stent mesh. According to the manufacturer, the Checkmate system is intended to interrupt this scar tissue growth in the vessel wall. This system uses the gamma-radiating source Iridium-192. Tiny seeds of Iridium-192 are encased in a source ribbon and delivered through a catheter to the site of blockage. The source ribbon is left in place for approximately 15 to 20 minutes and is then withdrawn.

The manufacturer reports that the system is comparable to a standard stent procedure in ease of use and there is a minimum requirement for additional equipment. In clinical trials, the radiation safety record of the Checkmate system was unsurpassed. In more than 1,000 patients treated in the United States, there were no reportable events.

The Checkmate system should not be used in patients in whom antiplatelet and/or anticoagulant therapy is contraindicated. Safety and efficacy have not been established in patients with previous intravascular brachytherapy of the same vessel segment or previous radiation treatment in the immediate vicinity, those who are pregnant, those with known genetic radiation sensitivity disorders and those with saphenous vein graft disease.

For more information on the Checkmate system, write to the manufacturer at Cordis Corporation, 14201 N.W 60th Ave., Miami Lakes, FL 33014; call 305-824-2000; or visit the manufacturer's Web site athttp://www.cordis.com.