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  1. Successful implementation of guidelines for encouraging the use of Beta blockers in patients after acute myocardial infarction.

    Article - En anglais

    PURPOSE 

    To assess whether implementation of guidelines increases the prescription of drugs, particularly bêta blockers, recommended for secondary prevention after acute myocardial infarction.

    SUBJECTS AND METHODS 

    Prescription patterns among 355 patients discharged from a public teaching hospital after recovery from myocardial infarction were prospectively monitored in a before-after trial.

    The implementation strategies included educational interventions (large group meetings), placement of guidelines in patients'records, and bimonthly general reminders sent to physicians.

    RESULTS 

    Beta blockers were prescribed in 93 (38%) of 243 survivors ofacute myocardial infarction before guideline implementation (12-month control period), as compared with 71 (63%) of 112 patients (P<0.001) after their implementation (6-month period).

    During the entire study period, the prescription of bêta blockers at a neighboring public teaching hospital, used as a comparison, was unchanged.

    After adjusting for potential confounders, implementation of the guidelines remained significantly associated with prescription of bêta blockers at discharge [odds ratio (OR)=10 ; 95% confidence interval (Cl), 3.2 to 33 ; P<0.001]. Other independent predictors of prescription of bêta blockers were previous coronary artery bypass grafting (OR=8.7 ; 95% Cl, 2.5 to 31 ; P=0.001), hypertension (OR=2.5 ; 95% Cl, 1.4 to 4.5 ; P=0.003), age per 10-year increase (OR=0.82 ; 95% CI, 0.67 to 0.99 ; P=0. (...)

    Mots-clés Pascal : Infarctus, Myocarde, Aigu, Bloquant bêta-adrénergique, Prévention, Secondaire, Implémentation, Guide pratique, Recommandation, Chimiothérapie, Efficacité, Homme, Appareil circulatoire pathologie, Cardiopathie coronaire, Myocarde pathologie

    Mots-clés Pascal anglais : Infarct, Myocardium, Acute, Beta blocking agent, Prevention, Secondary, Implementation, Handbook, Recommendation, Chemotherapy, Efficiency, Human, Cardiovascular disease, Coronary heart disease, Myocardial disease

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0280937

    Code Inist : 002B02F05. Création : 16/11/1999.