title: Improving cardiovascular disease management in Australia: NPS MedicineWise.
abstract: OBJECTIVE
  To determine the impact of four NPS MedicineWise programs targeting quality use of medicines in cardiovascular management in primary care.
  
  
  METHODS
  Interrupted time-series analysis using the Department of Veterans' Affairs (DVA) claims dataset from 1 January 2002 to 31 August 2010. We examined the use of antithrombotics in people with atrial fibrillation and in those who had had a stroke, and the use of echocardiography and spironolactone in the population with heart failure.
  
  
  METHODS
  All veterans and their dependants in Australia who had received cardiovascular medicines or health services related to the targeted intervention.
  
  
  METHODS
  NPS MedicineWise national programs to improve cardiovascular management in primary care, which included prescriber feedback, academic detailing, case studies and audits as well as printed educational materials.
  
  
  METHODS
  Changes in medication and health service use before and after the interventions.
  
  
  RESULTS
  All national programs were positively associated with significant improvements in related prescribing or test request practice. The interventions to improve the use of antithrombotics resulted in a 1.27% (95% CI, 1.26%-1.28%) and 0.63% (95% CI, 0.62%-0.64%) relative increase in the use of aspirin or warfarin in the population with atrial fibrillation 6 and 12 months after the program, respectively, and in a 1.51% (95% CI, 1.49%-1.53%) relative increase in the use of aspirin as monotherapy for secondary stroke prevention 12 months after the intervention. The heart failure programs resulted in a 3.69% (95% CI, 3.67%-3.71%) relative increase in the use of low-dose spironolactone and a 4.31% (95% CI, 4.27%-4.35%) relative increase in the use of echocardiogram tests 12 months after the intervention.
  
  
  CONCLUSIONS
  NPS MedicineWise programs were effective in achieving positive changes in medicine and health service use for patients with cardiovascular diseases.
authors.affiliation: University of South Australia, Adelaide, SA. svetla.gadzhanova@unisa.edu.au
authors.forename: Svetla V
authors.initials: SV
authors.lastname: Gadzhanova
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Roughead
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Bartlett
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D001315:Australia; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D016208:Databases, Factual; D019468:Disease Management; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*; D015397:Program Evaluation; D058996:Quality Improvement; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D001241:Aspirin