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 .
Improving the management of non-ST elevation acute coronary syndromes: systematic evaluation of a quality improvement programme European QUality Improvement Programme for Acute Coronary Syndrome: The EQUIP-ACS project protocol and design
Background Acute coronary syndromes , including myocardial infa rct ion and unstable angina , are important causes of premature mortality , morbidity and hospital admissions . Acute coronary syndromes consume large amounts of health care re sources , and have a major negative economic and social impact through days lost at work , support for disability , and coping with the psychological consequences of illness . Several registries have shown that evidence based treatments are under-utilised in this patient population , particularly in high-risk patients . There is evidence that systematic educational programmes can lead to improvement in the management of these patients . Since application of the results of important clinical trials and expert clinical guidelines into clinical practice leads to improved patient care and outcomes , we propose to test a quality improvement programme in a general group of hospitals in Europe . Methods / Design This will be a multi-centre cluster-r and omised study in 5 European countries : France , Spain , Pol and , Italy and the UK . Thirty eight hospitals will be r and omised to receive a quality improvement programme or no quality improvement programme . Centres will enter data for all eligible non-ST segment elevation acute coronary syndrome patients admitted to their hospital for a period of approximately 10 months onto the study data base and the sample size is estimated at 2,000 - 4,000 patients . The primary outcome is a composite of eight measures to assess aggregate potential for improvement in the management and treatment of this patient population ( risk stratification , early coronary angiography , anticoagulation , beta-blockers , statins , ACE-inhibitors , clopidogrel as a loading dose and at discharge ) . After the quality improvement programme , each of the eight measures will be compared between the two groups , correcting for cluster effect . Discussion If we can demonstrate important improvements in the quality of patient care as a result of a quality improvement programme , this could lead to a greater acceptance that such programmes should be incorporated into routine health training for health professionals and hospital managers . Trial registration Clinical trials.gov
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 .