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Pharmacy World and Science

, Volume 23, Issue 5, pp 177–178 | Cite as

Evaluation of the implementation of a local treatment guideline in secondary prevention post-myocardial infarction

  • F. Reid
  • B. Fossland
  • A.D. Flapan
  • C.C. Duckelmann
  • S.A. Hudson
Article

Abstract

Objective: to validate and implement an audit tool to assess quality and appropriateness of prescribing. To compare in‐patient prescribing of secondary prevention in post myocardial infarction patients before and after introduction of a local treatment guideline.

Method: descriptive, non‐experimental retrospective case note review comparing patients treated before and after the implementation of a clinical guideline.

Main outcome: comparison of quality of prescribing in two patient groups

Results: Analysis of Group1 patients showed that 41% required treatment with an angiotensin converting enzyme inhibitor (ACE‐I), and 23% of those did not receive treatment, 20% of patients on ACE‐I received sub‐therapeutic doses. Seventy‐two per cent of patients required treatment with a statin and 22% of those did not receive a statin. Comparison of the treatment of Group 2 showed that, of 53 patients (50% of Group 2) requiring an ACE‐I, 100% received it, although 15% received sub‐therapeutic doses. Of 69 patients (64% of Group 2) requiring treatment with a statin 96% were prescribed a statin. Improvements in prescribing of b‐Blockers, ACE‐I and statins were statistically significant.

Conclusions: Prescribing improved significantly for b‐Blockers, ACE‐I and statins after guideline introduction with anticipated benefits to patient outcomes.

ACE inhibitors Aspirin Audit Betablockers Clinical guideline Myocardial infarction Retrospective study Statins 

References

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    Bowker TJ, Clayton TC, Ingham J, McLennan NR, Hobson HL, Pyke ST et al. A British Cardiac Society survey of the potential for secondary prevention of coronary heart disease: ASPIRE. Heart 1996;75:334-42.Google Scholar
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    Campbell NC, Thain J, Deans HG, Ritchie LD, Rawles JM. Secondary prevention of coronary heart disease: baseline survey of provision in general practice. BMJ 1998;316:1430-4.Google Scholar
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    Mehta RH, Eagle KA. Secondary prevention in acute myocardial infarction. BMJ 1998;316:838-42.Google Scholar
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    Scottish Intercollegiate Guideline Network. Secondary prevention of Coronary Heart Disease following Myocardial Infarction. Edinburgh: SIGN; 2000. (SIGN publication no 41)Google Scholar

Copyright information

© Kluwer Academic Publishers 2001

Authors and Affiliations

  • F. Reid
    • 1
  • B. Fossland
    • 2
  • A.D. Flapan
    • 3
  • C.C. Duckelmann
    • 4
  • S.A. Hudson
    • 4
  1. 1.Lothian Pharmacy Practice Unit and Department of Pharmaceutical SciencesUniversity of StrathclydeGlasgowScotland, UK
  2. 2.Department of PharmacologyUniversity of TromsøNorway
  3. 3.Department of CardiologyLothian University Hospitals NHS TrustScotland UK
  4. 4.Department of Pharmaceutical SciencesUniversity of StrathclydeGlasgowScotland, UK

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