Evaluation of the implementation of a local treatment guideline in secondary prevention post-myocardial infarction.
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.
Reid
F
F
Lothian Pharmacy Practice Unit, Department of Pharmaceutical Sciences, University of Strathclyde, Taylor Street, Glasgow, Scotland, UK. fiona.reid@strath.ac.uk
Fossland
B
B
Flapa
A D
AD
Duckelmann
C C
CC
Hudson
S A
SA
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
D000806:Angiotensin-Converting Enzyme Inhibitors