title: Evaluation of the implementation of a local treatment guideline in secondary prevention post-myocardial infarction.
abstract: OBJECTIVE
  To validate and implement an audit tool to assess quality and appropriateness of prescribing. To compare inpatient prescribing of secondary prevention in post myocardial infarction patients before and after introduction of a local treatment guideline.
  
  
  METHODS
  Descriptive, non-experimental retrospective case note review comparing patients treated before and after the implementation of a clinical guideline.
  
  
  RESULTS
  Comparison of quality of prescribing in two patient groups.
  
  
  RESULTS
  Analysis of Group 1 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 beta-Blockers, ACE-I and statins were statistically significant.
  
  
  CONCLUSIONS
  Prescribing improved significantly for beta-Blockers, ACE-I and statins after guideline introduction with anticipated benefits to patient outcomes.
authors.affiliation: Lothian Pharmacy Practice Unit, Department of Pharmaceutical Sciences, University of Strathclyde, Taylor Street, Glasgow, Scotland, UK. fiona.reid@strath.ac.uk
authors.forename: F
authors.initials: F
authors.lastname: Reid
authors.forename: B
authors.initials: B
authors.lastname: Fossland
authors.forename: A D
authors.initials: AD
authors.lastname: Flapa
authors.forename: C C
authors.initials: CC
authors.lastname: Duckelmann
authors.forename: S A
authors.initials: SA
authors.lastname: Hudson
mesh_terms: D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit / Q000706:statistics & numerical data; D008875:Middle Aged; D009203:Myocardial Infarction / Q000517:prevention & control*; D017410:Practice Guidelines as Topic / Q000592:standards; D012189:Retrospective Studies
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors