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 .
Collaborative care intervention for stable ischemic heart disease.
BACKGROUND Accumulating evidence suggests that collaborative models of care enhance communication among primary care providers , improving quality of care and outcomes for patients with chronic conditions . We sought to determine whether a multifaceted intervention that used a collaborative care model and was directed through primary care providers would improve symptoms of angina , self-perceived health , and concordance with practice guidelines for managing chronic stable angina . METHODS We conducted a prospect i ve trial , cluster r and omized by provider , involving patients with symptomatic ischemic heart disease recruited from primary care clinics at 4 academically affiliated Department of Veterans Affairs health care systems . Primary end points were changes over 12 months in symptoms on the Seattle Angina Question naire , self-perceived health , and concordance with practice guidelines . RESULTS In total , 183 primary care providers and 703 patients participated in the study . Providers accepted and implemented 91.6 % of 701 recommendations made by collaborative care teams . Almost half were related to medications , including adjustments to β-blockers , long-acting nitrates , and statins . The intervention did not significantly improve symptoms of angina or self-perceived health , although end points favored collaborative care for 10 of 13 prespecified measures . While concordance with practice guidelines improved 4.5 % more among patients receiving collaborative care than among those receiving usual care ( P < .01 ) , this was mainly because of increased use of diagnostic testing rather than increased use of recommended medications . CONCLUSION A collaborative care intervention was well accepted by primary care providers and modestly improved receipt of guideline -concordant care but not symptoms or self-perceived health in patients with stable angina
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 .