OBJECTIVES: to identify organisational determinants of adherence to evidence-based drug treatments after @entity583 ( @entity583 ), under the hypothesis that low adherence is associated with higher mortality and risk of reinfarction. In particular, we investigated the effect of group vs. single handed practice and multi-professional practice characteristics on @entity1 ' adherence to polytherapy after @entity583 . DESIGN: retrospective cohort study. SETTING AND @entity1 : residents in the Local Health Authority of Bologna (Italy) who were discharged from any Italian hospital between 2008 and 2011 with a diagnosis of @entity583 , and followed-up for a year. MAIN OUTCOME MEASURES: adherence to at least three out of the four drug therapies recommended for secondary prevention of @entity583 ( @entity2246 , b-blockers, antiplatelet agents, @entity6817 ). @entity1 who had at least 80% of days of follow-up covered by drug doses were considered adherent. RESULTS: of the 4,828 post- @entity583 @entity1 , 31.6% were adherent to polytherapy. General practice characteristics were unrelated to adherence, whereas discharge from cardiology hospital wards was significantly associated with higher @entity1 ' adherence (OR 1.97; 95%CI 1.56-2.48). CONCLUSION: general practice organisational models are not associated with higher adherence to evidence-based medications after @entity583 , whereas cardiologists seem to play a key role in improving @entity1 adherence to polytherapy. Healthcare delivery models should be designed; in them, general practitioners are responsible for the provision of @entity1 -centred care pathways and for care co-ordination with other primary care professionals and specialists, and take an advocacy role for the @entity1 when needed.

[Organisational determinants of adherence to secondary prevention medications after XXXX ].

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'PARTICIPANTS'] @entity583 :: ('MESH:D009203', 'Disease') :: ['AMI', 'acute myocardial infarction'] @entity6817 :: ('D019821', 'Chemical') :: ['statins'] @entity2246 :: ('MESH:D008661', 'Disease') :: ['angiotensin-converting enzyme inhibitors/angiotensin receptor blockers']
@entity583 :: (MESH:D009203,Disease) :: ['acute myocardial infarction']
