title: Improving pharmacotherapy after myocardial infarction by group academic detailing using feedback data on a patient level.
abstract: 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.
authors.affiliation: Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands. m.e.vanderelst@pharm.uu.nl
authors.forename: Menno E
authors.initials: ME
authors.lastname: van der Elst
authors.forename: Marcel L
authors.initials: ML
authors.lastname: Bouvy
authors.forename: Cornelis J
authors.initials: CJ
authors.lastname: de Blaey
authors.forename: Anthonius
authors.initials: A
authors.lastname: de Boer
mesh_terms: 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
chemical_list: D002317:Cardiovascular Agents