Improving pharmacotherapy after myocardial infarction by group academic detailing using feedback data on a patient level.
OBJECTIVE
To develop and evaluate a peer review group (PRG) meeting using feedback data on a patient level to improve the quality of drug therapy for prevention of recurrent myocardial infarction.


METHODS
Prospective follow-up study.


METHODS
General practitioners' computerized patients records (intervention patients) and the PHARMO record linkage system (controls).


METHODS
Forty patients in the intervention group and 1030 control patients; both groups had documented myocardial infarction.


METHODS
The intervention, which was based on the principles of group academic detailing, consisted of scoring current cardiovascular treatment on separate forms for each patient, presenting an overview of, and discussing, evidence-based treatment after myocardial infarction, defining the target population, formulating a binding consensus, and identifying patients who were eligible for improvement of pharmacotherapy.


RESULTS
Drug therapy and adherence to the newly formulated PRG consensus were assessed at baseline and 1 year after the intervention. Of the patients who received the intervention and were not treated according to the PRG consensus at baseline, 40% received treatment according to the consensus 12 months after the PRG meeting. In the control group, the proportion of patients was 9.5% (prevalence ratio 4.2, 95% confidence interval 1.8-9.7).


CONCLUSIONS
Peer review group meetings can be a valuable tool for improving pharmacotherapy after myocardial infarction.
van der Elst
Menno E
ME
Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands. m.e.vanderelst@pharm.uu.nl
Bouvy
Marcel L
ML
de Blaey
Cornelis J
CJ
de Boer
Anthonius
A
D000368:Aged; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000517:prevention & control; D009426:Netherlands; D010348:Patient Care Team; D010380:Peer Review; D010593:Pharmaceutical Services / Q000592:standards*; D011446:Prospective Studies; D011787:Quality of Health Care; D055502:Secondary Prevention
D002317:Cardiovascular Agents