Does prescribing by a cardiologist-led team improve adherence to discharge standards for secondary prophylaxis post-MI compared to a general medical team?
An audit of post-MI discharge medications showed 65% adherence to secondary prophylaxis standards, with no significant difference between cardiology and general medical teams.
BACKGROUND AND OBJECTIVE: Prophylactic pharmacotherapy post-myocardial infarction (post-MI) has been shown to reduce the risk of subsequent non-fatal infarction and to reduce overall mortality. The present study aimed to review the therapy of such patients in a teaching hospital. METHOD: Medicines prescribed to 77 post-MI patients for secondary prophylaxis were reviewed. The drugs prescribed by a cardiologist-led team were compared with those prescribed by a general medical team. Seventeen patients died before discharge, leaving a study cohort of 60 patients to complete the audit. RESULTS: Thirty-nine of the 60 patients (65%) met the discharge standard, and there was no significant difference in adherence to the audit standard when the consultant cardiologist and the general medical consultant were compared. The audit highlighted the therapeutic dilemma concerning the appropriateness of initiating low-dose aspirin in patients already receiving warfarin therapy. CONCLUSION: The audit has enabled us to develop guidelines which feed into the multi-disciplinary cardiac rehabilitation programme, helping to improve prescribing adherence to the discharge standard. A follow-up audit is planned.
Richardson et al. (Sun,) studied this question.
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