Conclusions Organisational and professional interventions improved prescribing of statins/lipid-lowering agents and target blood pressure in patients with IHDs but there was little evidence of change in other outcomes .
Objectives Ischaemic heart diseases ( IHDs ) are a leading cause of death worldwide .
Although prescribing according to guidelines improves health outcomes , it remains suboptimal .
We determined whether interventions targeted at healthcare professionals are effective to enhance prescribing and health outcomes in patients with IHDs .
A multifaceted intervention to narrow the evidence-based gap in the treatment of acute coronary syndromes: rationale and design of the Brazilian Intervention to Increase Evidence Usage in Acute Coronary Syndromes (BRIDGE-ACS) cluster-randomized trial.
Translating evidence into clinical practice in the management of acute coronary syndromes ( ACS ) is challenging . Few ACS quality improvement interventions have been rigorously evaluated to determine their impact on patient care and clinical outcomes . We design ed a pragmatic , 2-arm , cluster-r and omized trial involving 34 clusters ( Brazilian public hospitals ) . Clusters were r and omized to receive a multifaceted quality improvement intervention ( experimental group ) or routine practice ( control group ) . The 6-month educational intervention included reminders , care algorithms , a case manager , and distribution of educational material s to health care providers . The primary end point was a composite of evidence -based post-ACS therapies within 24 hours of admission , with the secondary measure of major cardiovascular clinical events ( death , nonfatal myocardial infa rct ion , nonfatal cardiac arrest , and nonfatal stroke ) . Prescription of evidence -based therapies at hospital discharge were also evaluated as part of the secondary outcomes . All analyses were performed by the intention-to-treat principle and took the cluster design into account using individual-level regression modeling ( generalized estimating equations ) . If proven effective , this multifaceted intervention would have wide use as a means of promoting optimal use of evidence -based interventions for the management of ACS
Conclusions Organisational and professional interventions improved prescribing of statins/lipid-lowering agents and target blood pressure in patients with IHDs but there was little evidence of change in other outcomes .
Objectives Ischaemic heart diseases ( IHDs ) are a leading cause of death worldwide .
Although prescribing according to guidelines improves health outcomes , it remains suboptimal .
We determined whether interventions targeted at healthcare professionals are effective to enhance prescribing and health outcomes in patients with IHDs .