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K. Jolly, F. Bradley, S. Sharp, Helen Smith, S. Thompson, A. Kinmonth (1999)
General practice Randomised controlled trial of follow up care in general practice of patients with myocardial infarction and angina : final results of the Southampton heart integrated care project ( SHIP )
M. Moher, Patricia Yudkin, Rebecca Turner, Theo Schofield, David Mant (2000)
An assessment of morbidity registers for coronary heart disease in primary care. ASSIST (ASSessment of Implementation STrategy) trial collaborative group.The British journal of general practice : the journal of the Royal College of General Practitioners, 50 458
G. Feder, C. Griffiths, S. Eldridge, Matthew Spence (1999)
Effect of postal prompts to patients and general practitioners on the quality of primary care after a coronary event (POST): randomised controlled trialBMJ, 318
N. Campbell, L. Ritchie, J. Thain, H. Deans, J. Rawles, J. Squair (1998)
Secondary prevention in coronary heart disease: a randomised trial of nurse led clinics in primary careHeart, 80
A. Brady, M. Oliver, J. Pittard, Flanagan Deh, P. Cox, Paine Davies, Armitage Preven, Clayton Tc, Mclennan Nr, Hobson Hl, Pyke Sd, B. Schofield (2001)
Secondary prevention in 24 431 patients with coronary heart disease: survey in primary careBMJ : British Medical Journal, 322
Carlos Brotons, F. Calvo, P. Cascant, Aida Ribera, I. Moral, G. Permanyer-Miralda (1998)
Is prophylactic treatment after myocardial infarction evidence-based?Family practice, 15 5
Background. Despite best practice, it may not be achievable in some patients to reach the optimal goals of secondary prevention recommendations for various reasons, such as co-morbidity, contraindications for some drugs or side effects. Objective. Our aim was to estimate the achievable standards for audit purposes in primary care for prophylactic treatment of secondary prevention of myocardial infarction. Methods. We conducted a survey of consecutive patients with a hospital diagnosis of first acute myocardial infarction during 1997 who were identified from discharge books from four hospitals and interviewed at their primary health centre 2 years after admission. The achievable standard for a prophylactic drug was then defined as the proportion of patients that could benefit from the treatment excluding those that for one justified reason or another were off medication. Results. Three hundred and sixty-nine patients were interviewed in the follow-up. Aspirin or another antiplatelet regimen was prescribed in 86.9 patients, β-blockers in 50.2%, angiotensin-converting enzyme (ACE) inhibitors in 32.5% and lipid-lowering drugs in 52%. The estimated achievable standards for those prescribed drugs were 94.5, 71,8, 50.5 and 69.8%, respectively. Conclusions. There is an underuse of prophylactic drug therapies after myocardial infarction. The standards established in this study for secondary preventive drug treatment might be achieved through a reasonable effort by GPs working in primary care committed to improving the quality of care. Key words
Family Practice – Oxford University Press
Published: Feb 1, 2003
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