title: Assessment of drug treatment quality in two Danish health-care centres.
abstract: BACKGROUND
  Bridging the primary and secondary sector, health-care centres aim to reduce morbidity and prevent further hospitalization in patients with chronic heart diseases. The aim of this study was to describe the quality of drug treatment in patients with chronic heart diseases in two Copenhagen health-care centres.
  
  
  METHODS
  Over a period of three months, 28 patients with heart failure (HF) or ischaemic heart disease (IHD) were included. The participants were interviewed and clinically examined.
  
  
  RESULTS
  The patients received an average of nine drugs, and only about one third were clinically well-treated. Among IHD patients, 74% received beta blockers and 64% angiotensin converting enzyme-inhibitors (ACE-I) as indicated. All received statins and 92% acetylsalicylic acid. Among HF patients, 67% received ACE-I, 87% beta blockers and 77% diuretics as indicated. Overall, 10%, 31% and 40% of the HF patients received smaller than recommended doses of ACE-I, beta blockers, and diuretics, respectively. In 68% of the patients, 35 potential drug interactions were identified, none of which were deemed potentially harmful.
  
  
  CONCLUSIONS
  This small descriptive study indicates that patients in health-care centres might be undertreated and receive drug therapy only partly in accordance with the guidelines. However, since we had no access to medical charts, any reasons for not treating patients with a certain drug or selecting a lower than recommended dose could not be evaluated. Nevertheless, patients may benefit from closer involvement of clinicians or GPs in the multidisciplinary teams of the health-care centres.
authors.affiliation: Department of Surgical Gastroenterology, Herlev Hospital.
authors.forename: Kajsa
authors.initials: K
authors.lastname: Edfors
authors.forename: Stig Ejdrup
authors.initials: SE
authors.lastname: Andersen
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D003718:Denmark; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000188:drug therapy*; D036301:Qualitative Research; D011787:Quality of Health Care / Q000592:standards* / Q000706:statistics & numerical data; D013148:Spironolactone / Q000627:therapeutic use
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D013148:Spironolactone; D001241:Aspirin