[Cracovian program for secondary prevention of ischemic heart disease. Secondary prevention of ischemic heart disease during hospitalization in 1996-97 and 1998-99].
BACKGROUND
Hospitalization for ischaemic heart disease is a convenient moment to initiate pharmacological and non-pharmacological treatment as well as education of patients. The aim of the study was to assess the quality of medical care in the field of secondary prevention in patients hospitalized for ischaemic heart disease in cardiac departments of university and general hospitals in 1998/99 as compared with 1996/97.


METHODS
Consecutive patients were recruited on the basis of hospital records review of six cardiac departments (three in the university and three in general hospitals) in 1998/99. Inclusion criteria were: age < or = 70 years, inhabitance in the city of Cracow and its province and hospitalization due to: myocardial infarction, unstable angina, coronary angioplasty or coronary-aortic bypass grafting.


METHODS
Hospital records of the included patients were reviewed. Data on previous history of ischaemic heart disease, on risk factors (including smoking, hypertension, diabetes, dyslipidemia, obesity) and drugs prescribed at discharge were obtained based on a predefined questionnaire.


RESULTS
The frequency of blood pressure measurement in the first 24 hours of hospitalization was 88.8% in 1996/97 vs 95.7% in 1998/99 (p < 0.001). In the first 24 hours after admission total cholesterol concentration was measured in 32.8% and 45.0% of patients (p < 0.001), HDL cholesterol in 30.2% and 41.9% (p < 0.001) and triglycerides in 32.3% and 44.5% (p < 0.001), respectively. Both height and body mass were documented in 54.3% and 61.7% (p < 0.05) of the reviewed charts. Antiplatelet drugs were prescribed at discharge in 86.7% and 90.7% of patients (p < 0.05), beta-blockers in 66.4% and 61.9%, ACE inhibitors in 50.2% and 52.8%, while lipid lowering drugs in 27.1% and 41.6% (p < 0.001), respectively.


CONCLUSIONS
In 1998/99 compared with 1996/97 the quality of care in the field of secondary prevention of ischaemic heart disease was improved in cardiac departments of university and general hospitals in Cracow.
Pajak
Andrzej
A
Zakład Epidemiologii Klinicznej i Badań Populacyjnych Instytutu Zdrowia Publicznego Collegium Medicum Uniwersytetu Jagiellońskiegio w Krakowie, 31-501 Kraków, ul. Kopernika 17.
Kawecka-Jaszcz
Kalina
K
Jankowski
Piotr
P
Bilo
Grzegorz
G
Dubiel
Jacek S
JS
Maciejewicz
Janusz
J
Piotrowski
Wiesław
W
Smielak-Korombel
Wanda
W
Tracz
Wiesława
W
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002391:Catchment Area, Health; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006760:Hospitalization; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D017202:Myocardial Ischemia / Q000188:drug therapy / Q000517:prevention & control* / Q000534:rehabilitation*; D011044:Poland; D011314:Preventive Health Services / Q000458:organization & administration / Q000639:trends*; D015397:Program Evaluation
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D004232:Diuretics; D000960:Hypolipidemic Agents