Evidence-based interventions in primary care following acute coronary syndrome in Australia and New Zealand: a systematic scoping review

Bhagwat, Manavi M.; Woods, John A.; Dronavalli, Mithilesh; Hamilton, Sandra J.; Thompson, Sandra C.

doi:10.1186/s12872-016-0388-y

Cited by 11 publications

(10 citation statements)

References 39 publications

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“…However, GPs are more likely to prescribe ACS medications than to assist in lifestyle or psychological management, so the referral to CR programs which offer comprehensive lifestyle interventions remains important. Data are limited on interventions that are effective in improving general practitioner management in rural, minority, and Indigenous populations [56].…”

Section: Cardiac Rehabilitation and Availability Of Services For Secomentioning

confidence: 99%

Challenges in Managing Acute Cardiovascular Diseases and Follow Up Care in Rural Areas: A Narrative Review

Thompson

Nedkoff

Katzenellenbogen

et al. 2019

IJERPH

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This narrative review explores relevant literature that is related to the challenges in implementing evidence-based management for clinicians in rural and remote areas, while primarily focussing on management of acute coronary syndrome (ACS) and follow up care. A targeted literature search around rural/urban differences in the management of ACS, cardiovascular disease, and cardiac rehabilitation identified multiple issues that are related to access, including the ability to pay, transport and geographic distances, delays in patients seeking care, access to diagnostic testing, and timely treatment in an appropriate facility. Workforce shortages or lack of ready access to relevant expertise, cultural differences, and complexity that arises from comorbidities and from geographical isolation amplified diagnostic challenges. Given the urgency in management of ACS, rural clinicians must act quickly to achieve optimal patient outcomes. New technologies and quality improvement approaches enable better access to rapid diagnosis, as well as specialist input and care. Achieving an uptake of cardiac rehabilitation in rural and remote settings poses challenges that may reduce with the use of alternative models to centre-based rehabilitation and use of modern technologies. Expediting improvement in cardiovascular outcomes and reducing rural disparities requires system changes and that clinicians embrace attention to prevention, emergency management, and follow up care in rural contexts.

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Section: Cardiac Rehabilitation and Availability Of Services For Secomentioning

confidence: 99%

Challenges in Managing Acute Cardiovascular Diseases and Follow Up Care in Rural Areas: A Narrative Review

Thompson

Nedkoff

Katzenellenbogen

et al. 2019

IJERPH

Self Cite

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“…myocardial infarction) with hospital admission, prescription rates for APT, as part of a secondary preventive strategy, are usually high [4][5][6][7][8][9][10], but do not reach 100%. Age, female sex, race, polypharmacy due to comorbidities, and coding problems (among others) are variables which have been shown to have a negative impact on prescription rates at hospital discharge [11][12][13][14][15][16][17].…”

Section: Discussionmentioning

confidence: 99%

“…All the aforementioned variables also negatively influence long-term adherence, which has further been shown to decline due to poor health literacy, cognitive or psychic impairment, and medication cost issues (among others) [18][19][20][21]. Long-term adherence to APT has been reported to decline substantially over time [17,22,23,24,25,26,27,28], but more favourable results have also been reported [5,6,10,12,[18][19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Prescription Rates for Antiplatelet Therapy (APT) in Coronary Artery Disease (CAD) – What Benchmark are We Aiming at in Continuing Medical Education (CME)?

Hagen

Griebenow

2020

Journal of European CME

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Physicians always aim to improve their patients' health. CME should be designed not only to provide knowledge transfer, but also to influence clinical decision-making and to close performance gaps. In aretrospective study we analysed prescription rates for APT in 254,932 CAD patients (male: 64.4%), treated in atotal of 3,405 practices in 2019 in aDMP in the region of North Rhine, Germany. Analyses were run for the whole study population stratified by sex as well as for subgroups of patients suffering from myocardial infarction/acute coronary syndrome, or who have been treated with percutaneous coronary intervention or bypass surgery. Patients mean age was 72.7 ± 11.2 years (mean ± 1SD), mean duration of DMP participation was 7.2 ± 4.7 years, and mean cumulative number of DMP visits was 27 ± 17. APT prescription rates were 85.0% in male and 78.8% in female CAD patients. In subgroups of male CAD patients APT prescription rates were between 89.7% and 92.8%, in the same subgroups of female CAD patients the corresponding rates were between 87.8% and 92.0%. Rates for amissing APT prescription per practice were between .0044% and .0062% for male and female CAD patients, respectively. Rates for amissing APT prescription per practice and DMP visit were .0002% for both sexes. These results suggest that a DMP can achieve high attainment rates for APT in CAD. To further improve attainment rates, consideration of absolute numbers of eligible patients per practice or physician is probably more appropriate than expression of performance as percentage values. This is especially true if attainment rates show substantial variations between subgroups, if subgroups show substantial variation in size, if attainment rates are already in the magnitude of 80% or higher, and if there are disparities in the evidence base underlying treatment recommendations related to subgroups.

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“…It can rapidly restore myocardial reperfusion, quickly alleviate myocardial hypoxia/ischemia, and reduces AMI patients’ mortality [ 6 ]. Although PCI can quickly relieve symptoms, many patients still suffer from myocardial damage, poor mental state and decreasing motor ability [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of Exercise-Based Cardiac Rehabilitation on Left Ventricular Function in Asian Patients with Acute Myocardial Infarction after Percutaneous Coronary Intervention: A Meta-Analysis of Randomized Controlled Trials

Wang

Chien

et al. 2021

Healthcare

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(1) Background: The effects of exercise-based cardiac rehabilitation (CR) on left ventricular function in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) are important but poorly understood. (2) Purpose: To evaluate the effects of an exercise-based CR program (exercise training alone or combined with psychosocial or educational interventions) compared with usual care on left ventricular function in patients with AMI receiving PCI. (3) Data sources, study selection and data extraction: We searched PubMed, WEB OF SCIENCE, EMBASE, EBSCO, PsycINFO, LILACS and Cochrane Central Register of Controlled Trials databases (CENTRAL) up to 12th June 2021. Article selected were randomized controlled trials and published as a full-text article. Meta-analysis was conducted with the use of the software Review manager 5.4. (4) Data synthesis: Eight trials were included in the meta-analysis, of which three trials were rated as high risk of bias. A significant improvement was seen in the exercise-based CR group compared with the control group regarding left ventricular ejection fraction (LVEF) (std. mean difference = 1.33; 95% CI:0.43 to 2.23; p = 0.004), left ventricular end-diastolic dimension (LVEDD) (std. mean difference = −3.05; 95% CI: −6.00 to −0.09; p = 0.04) and left ventricular end-systolic volume (LVESV) (std. mean difference = −0.40; 95% CI: −0.80 to −0.01; p = 0.04). Although exercise-based CR had no statistical effect in decreasing left ventricular end-systolic dimension (LVESD) and left ventricular end-diastolic volume (LVEDV), it showed a favorable trend in relation to both. (5) Conclusions: Exercise-based CR has beneficial effects on LV function and remodeling in AMI patients treated by PCI.

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Evidence-based interventions in primary care following acute coronary syndrome in Australia and New Zealand: a systematic scoping review

Cited by 11 publications

References 39 publications

Challenges in Managing Acute Cardiovascular Diseases and Follow Up Care in Rural Areas: A Narrative Review

Challenges in Managing Acute Cardiovascular Diseases and Follow Up Care in Rural Areas: A Narrative Review

Prescription Rates for Antiplatelet Therapy (APT) in Coronary Artery Disease (CAD) – What Benchmark are We Aiming at in Continuing Medical Education (CME)?

Effect of Exercise-Based Cardiac Rehabilitation on Left Ventricular Function in Asian Patients with Acute Myocardial Infarction after Percutaneous Coronary Intervention: A Meta-Analysis of Randomized Controlled Trials

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