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Current discharge management of acute coronary syndromes: baseline results from a national quality improvement initiative

Citation

Wai, A and Pulver, LK and Oliver, K and Thompson, A, Current discharge management of acute coronary syndromes: baseline results from a national quality improvement initiative, Internal Medicine Journal, 42, (5) pp. e53-e59. ISSN 1444-0903 (2012) [Refereed Article]

Copyright Statement

Copyright 2010 the authors and Royal Australasian College of Physicians.

DOI: doi:10.1111/j.1445-5994.2010.02308.x

Abstract

Background: Evidence–practice gaps exist in the continuum of care for patients with acute coronary syndromes (ACS), particularly at hospital discharge. Aim: We aimed to describe the methodology and baseline results of the Discharge Management of Acute Coronary Syndromes (DMACS) project, focusing on the prescription of guideline-recommended medications, referral to cardiac rehabilitation and communication between the hospital, patient and their primary healthcare professionals. Methods: DMACS employed Drug Use Evaluation methodology involving data collection,evaluation and feedback, and targeted educational interventions. Adult patients with ACS discharged during a 4-month period were eligible to participate. Data were collected (maximum 50 patients) at each site through an inpatient medical record review, a general practitioner (GP) postal/fax survey conducted 14 days post discharge and a patient telephone survey 3 months post discharge. Results: Forty-nine hospitals participated in the audit recruiting 1545 patients. At discharge, 57% of patients were prescribed a combination of antiplatelet agent(s), beta-blocker, statin and angiotensin-converting enzyme inhibitor and/or angiotensin II-antagonist. At 3 months post discharge, 48% of patients reported using the same combination. Some 67% of patients recalled being referred to cardiac rehabilitation; of these, 33% had completed the programme. In total, 83% of patients had a documented ACS management plan at discharge. Of these, 90% included a medication list, 56% a chest pain action plan and 54% risk factor modification advice. Overall, 65% of GPs rated the quality of information received in the discharge summary as ‘very good’ to ‘excellent’. Conclusions: The findings of our baseline audit showed that despite the robust evidence base and availability of national guidelines, the management of patients with ACS can be improved. These findings will inform a multifaceted intervention strategy to improve adherence to guidelines for the discharge management of patients with ACS.

Item Details

Item Type:Refereed Article
Keywords:Discharge management, acute coronary syndromes,quality improvement
Research Division:Medical and Health Sciences
Research Group:Pharmacology and Pharmaceutical Sciences
Research Field:Clinical Pharmacology and Therapeutics
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
Author:Thompson, A (Mr Angus Thompson)
ID Code:65470
Year Published:2012
Web of Science® Times Cited:12
Deposited By:Pharmacy
Deposited On:2010-11-17
Last Modified:2013-05-10
Downloads:0

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