[Effect of a simple educational program for physicians on adherence to secondary prevention measures after discharge following acute coronary syndrome. The CAM Project].
OBJECTIVE
Adherence to established guidelines for patients discharged from the hospital after acute coronary syndrome is known to be suboptimal. The aim of this study was to assess the efficacy of a program for physicians centered on the treatment of acute coronary syndrome.


METHODS
39 hospitals participated.


METHODS
a set of measures was developed by consensus for the creation and distribution of educational materials.


METHODS
Proportion of patients in whom ejection fraction and residual ischemia were evaluated, treatment at discharge, and health and dietary recommendations to patients (smoking, diet, exercise, etc.) referred to all patients in whom these measures or treatments should have been used ("ideal patients"). Changes were assessed with four cross-sectional surveys.


RESULTS
A total of 1157, 1162, 1149 and 1158 patients were included. There were no relevant differences between these groups in baseline characteristics. In general, there was improvement in all variables between the first and the last survey. The proportion of patients who were weighed and measured increased (from 33.5% to 53.4%; P<.0001), as did the proportion of those in whom cholesterol was measured early (42.6 to 53.7%; P=.006). The proportion in whom residual ischemia was not measured despite indications for this test decreased (18.2% to 10.8%; P=.013), and the proportion increased for appropriate treatment with statins on discharge (68.6% to 81.4%; P<.0001), advice to quit smoking (60.1% to 72.2%; P<.0001) and advice to exercise (58.3% to 67.4%; P=.003).


CONCLUSIONS
The educational intervention seems to have had a positive effect on improving the appropriateness of procedures and treatments for patients discharged after acute coronary syndrome.
Muñiz García
Javier
J
Instituto de Ciencias de la Salud de la Universidad de La Coruña, La Coruña, Spain. javmu@udc.es
Gómez Doblas
Juan J
JJ
Santiago Pérez
María I
MI
de Teresa Galván
Eduardo
E
Cruz Fernández
José M
JM
Castro Beiras
Alfonso
A
D000368:Aged; D002317:Cardiovascular Agents / Q000627:therapeutic use; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D003327:Coronary Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D004501:Education, Medical / Q000379:methods; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D010820:Physicians; D015397:Program Evaluation; D012307:Risk Factors
D002317:Cardiovascular Agents