OBJECTIVE: To determine whether multidisciplinary disease management programmes for @entity1 with @entity301 improve processes of care and reduce morbidity and mortality. DATA SOURCES: Randomised clinical trials of disease management programmes in @entity1 with @entity301 were identified by searching Medline 1966-2000, Embase 1980-99, CINAHL 1982-99, SIGLE 1980-99, the Cochrane controlled trial register, the Cochrane effective practice and organisation of care study register, and bibliographies of published studies. DATA EXTRACTION: Studies were selected and data were extracted independently by two investigators, and summary risk ratios were calculated by using both the random effects model and the fixed effects model. DATA SYNTHESIS: A total of 12 trials (9803 @entity1 with @entity301 ) were identified. Disease management programmes had positive impacts on processes of care. @entity1 randomised to these programmes were more likely to be prescribed efficacious drugs (risk ratio 2.14 (95% confidence interval 1.92 to 2.38) for lipid lowering drugs, 1.19 (1.07 to 1.32) for beta blockers, and 1.07 (1.03 to 1.11) for antiplatelet agents). Five out of seven trials evaluating risk factor profiles showed significantly greater improvements with these programmes in comparison with usual care (with effect sizes in the moderate range). Summary risk ratios were 0.91 (0.79 to 1.04) for all cause mortality, 0.94 (0.80 to 1.10) for recurrent @entity583 , and 0.84 (0.76 to 0.94) for admission to hospital. Five of the eight trials evaluating quality of life or functional status reported better outcomes in the intervention arms. Only three of these trials reported the costs of the intervention-the interventions were cost saving in two cases. CONCLUSIONS: Disease management programmes improve processes of care, reduce admissions to hospital, and enhance quality of life or functional status in @entity1 with @entity301 . The programmes' impact on survival and recurrent @entity1188 , their cost effectiveness, and the optimal mix of components remain uncertain.

Randomised trials of secondary prevention programmes in XXXX : systematic review.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction'] @entity1188 :: ('MESH:D007238', 'Disease') :: ['infarctions'] @entity301 :: ('MESH:D003327', 'Disease') :: ['coronary heart disease']
@entity301 :: (MESH:D003327,Disease) :: ['coronary heart disease']
