MISSION!: optimization of acute and chronic care for patients with acute myocardial infarction.
BACKGROUND
Guideline implementation programs for patients with acute myocardial infarction (AMI) enhance adherence to evidence-based medicine (EBM) and improve clinical outcome. Although undertreatment of patients with AMI is well recognized in both acute and chronic phases of care, most implementation programs focus on acute and secondary prevention strategies during the index hospitalization phase only.


OBJECTIVE
Implementation of an all-phase integrated AMI care program maximizes EBM in daily practice and improves the care for patients with AMI.


OBJECTIVE
The objective of this study is to assess the effects of the MISSION! program on adherence to EBM for patients with AMI by the use of performance indicators.


METHODS
The MISSION! protocol is based on the most recent American College of Cardiology/American Heart Association and European Society of Cardiology guidelines for patients with AMI. It contains a prehospital, inhospital, and outpatient clinical framework for decision making and treatment, up to 1 year after the index event. MISSION! concentrates on rapid AMI diagnosis and early reperfusion, followed by active lifestyle improvement and structured medical therapy. Because MISSION! covers both acute and chronic AMI phase, this design implies an intensive multidisciplinary collaboration among all regional health care providers.


CONCLUSIONS
Continuum of care for patients with AMI is warranted to take full advantage of EBM in day-to-day practice. This manuscript describes the rationale, design, and preliminary results of MISSION!, an all-phase integrated AMI care program.
Liem
Su-San
SS
Leiden University Medical Center, Leiden, The Netherlands.
van der Hoeven
Barend L
BL
Oemrawsingh
Pranobe V
PV
Bax
Jeroen J
JJ
van der Bom
Johanna G
JG
Bosch
Jan
J
Viergever
Eric P
EP
van Rees
Cees
C
Padmos
Iman
I
Sedney
Meredith I
MI
van Exel
Henk J
HJ
Verwey
Harriette F
HF
Atsma
Douwe E
DE
van der Velde
Enno T
ET
Jukema
J Wouter
JW
van der Wall
Ernst E
EE
Schalij
Martin J
MJ
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D002985:Clinical Protocols; D003191:Comprehensive Health Care / Q000592:standards*; D003266:Continuity of Patient Care; D003299:Cooperative Behavior; D019317:Evidence-Based Medicine; D005260:Female; D019983:Guideline Adherence / Q000458:organization & administration*; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000534:rehabilitation / Q000628:therapy*; D009426:Netherlands; D010348:Patient Care Team / Q000592:standards; D017410:Practice Guidelines as Topic; D019984:Quality Indicators, Health Care; D015912:Thrombolytic Therapy; D014218:Triage