An electronic patient and family education system significantly increased the prescription rate of all four guideline-recommended drugs after ACS (39.32% vs 14.47%; p<0.001).
Cohort (n=282)
No
Does an electronic-based patient and family education system improve physicians' adherence to prescribing guideline-recommended secondary prevention medications in patients with acute coronary syndrome?
Implementation of an electronic-based patient and family education system significantly increased physicians' adherence to prescribing guideline-directed medical therapy for secondary prevention after acute coronary syndrome.
Absolute Event Rate: 39.32% vs 14.47%
p-value: p=<0.001
BACKGROUND: Prescription of guideline-recommended medicines after acute coronary syndrome (ACS) has been suboptimal. Tools for improving the use of medications have been developed, but they mainly targeted physicians. OBJECTIVE: We evaluated the effects of reinforcement of patient and family education on the usage of guideline-recommended secondary prevention medications. METHODS: This was a retrospective analysis of a prospectively collected registry of patients with ACS who were admitted to a regional teaching hospital in Taiwan between February 2015 and April 2017. The control group included 76 patients discharged before implementing the electronic-based patient and family education (PFE) system. The intervention group included 206 patients discharged after implementation. The primary outcome was the prescription rate of all four guideline-recommended drugs. Predictors of adherence were also evaluated. RESULTS: The study cohort included 282 ACS patients (188 men and 94 women) with a mean age of 68.5 years (standard deviation, 14.2). The intervention group patients were younger, had more family history of premature cardiovascular disease, more dyslipidemia, and underwent more reperfusion therapy. The intervention group was prescribed more guideline-recommended drugs than the control group: dual antiplatelet agents, 79.61% vs. 47.37% (p<0.001); statins, 74.76% vs. 34.21% (p<0.001); beta-blockers, 81.07% vs. 46.05% (p<0.001); angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, 62.62% vs. 38.16% (p<0.001); and a combination of all four medications, 39.32% vs. 14.47% (p<0.001). After adjusting baseline variables, the PFE system remained a significant contributor to adherence to these drugs use (P = 0.02). CONCLUSIONS: Reinforcement of patient education was associated with significant improvements in physicians' adherence to guideline-recommended medical therapy after acute coronary syndrome.
Lee et al. (Thu,) conducted a cohort in Acute coronary syndrome (n=282). Electronic-based patient and family education (PFE) system vs. Discharge before implementing the PFE system was evaluated on Prescription rate of all four guideline-recommended drugs (p=<0.001). An electronic patient and family education system significantly increased the prescription rate of all four guideline-recommended drugs after ACS (39.32% vs 14.47%; p<0.001).