The drug knowledge of 107 patients was determined before and after entering a self-medication scheme on the post-coronary care unit (PCCU) at City Hospital, Birmingham, and approximately 6 weeks post-discharge when these patients attended their cardiac rehabilitation classes. Fifty-two completed questionnaires were returned. The results indicated a general increase in patients knowledge about the names and side-effects of their drugs, the times at which they take them and the reasons for taking them, following self-medication. A smaller number of questionnaires (19) were completed 6 weeks after discharge. The responses to these suggested that patients who self-medicated in hospital showed greater drug knowledge, especially with regard to potential side-effects, than those who had not. Patients' confidence in their ability to self-medicate safely at home showed no relation to their actual knowledge. It is suggested that self-medication on the PCCU is an important part of the cardiac rehabilitation programme.
Despite advances in the investigation and treatment of angina and myocardial infarction, and increased knowledge of the factors associated with the development and progression of ischaemic heart disease, it remains the leading cause of death and morbidity in the majority of industrialized countries. Cardiac rehabilitation provides a means of modifying lifestyle and other risk factors in patients presenting with established, symptomatic coronary artery disease, thereby reducing the risk of further cardiac events. It has also been proven to be cost-efficient.
Diabetes mellitus affects 2% of the population and up to 5% of people over 65 years of age (Thomas, 1993). Diabetic patients have more coronary artery disease and a higher mortality from acute myocardial infarction (AMI) than the rest of the population (Patmore and Jennings, 1996). They have similar-size infarcts to those without diabetes, but the total mortality post-MI is higher (Karlson et al, 1993). This article examines the literature on AMI in diabetic patients to ascertain the most effective management of these patients and hence improve their prognosis.
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