Objectives To determine whether postal prompts to patients who have survived an acute coronary event and to their general practitioners improve secondary prevention of coronary heart disease.
Design Randomised controlled trial.
Setting 52 general practices in east London, 44 of which had received facilitation of local guidelines for coronary heart disease.
Participants 328 patients admitted to hospital for myocardial infarction or unstable angina.
Interventions Postal prompts sent 2 weeks and 3 months after discharge from hospital.
The prompts contained recommendations for lowering the risk of another coronary event, including changes to lifestyle, drug treatment, and making an appointment to discuss these issues with the general practitioner or practice nurse.
Main outcome measures Proportion of patients in whom serum cholesterol concentrations were measured ; proportion of patients prescribed bêta blockers (6 months after discharge) ; and proportion of patients prescribed cholesterol lowering drugs (1 year after discharge).
Results Prescribing of bêta bockers (odds ratio 1.7,95% confidence interval 0.8 to 3.0, P>0.05) and cholesterol lowering drugs (1.7,0.8 to 3.4, P>0.05) did not differ between intervention and control groups.
A higher proportion of patients in the intervention group (64%) than in the control group (38%) had their serum cholesterol concentrations measured (2.9,1.5 to 5.5, P<0.001). (...)
Mots-clés Pascal : Cardiopathie coronaire, Aigu, Randomisation, Soin intégré, Qualité service, Efficacité, Guide pratique, Poste, A domicile, Médecin généraliste, Essai clinique, Questionnaire, Prévention, Récidive, Grande Bretagne, Royaume Uni, Europe, Homme, Appareil circulatoire pathologie
Mots-clés Pascal anglais : Coronary heart disease, Acute, Randomization, Managed care, Service quality, Efficiency, Handbook, Postal service, At home, General practitioner, Clinical trial, Questionnaire, Prevention, Relapse, Great Britain, United Kingdom, Europe, Human, Cardiovascular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0321412
Code Inist : 002B12A03. Création : 16/11/1999.