F Reid1, B Fossland, A D Flapa, C C Duckelmann, S A Hudson. 1. Lothian Pharmacy Practice Unit, Department of Pharmaceutical Sciences, University of Strathclyde, Taylor Street, Glasgow, Scotland, UK. fiona.reid@strath.ac.uk
Abstract
OBJECTIVE: To validate and implement an audit tool to assess quality and appropriateness of prescribing. To compare inpatient prescribing of secondary prevention in post myocardial infarction patients before and after introduction of a local treatment guideline. METHOD: Descriptive, non-experimental retrospective case note review comparing patients treated before and after the implementation of a clinical guideline. MAIN OUTCOME: Comparison of quality of prescribing in two patient groups. RESULTS: Analysis of Group 1 patients showed that 41% required treatment with an angiotensin converting enzyme inhibitor (ACE-I), and 23% of those did not receive treatment, 20% of patients on ACE-I received sub-therapeutic doses. Seventy-two per cent of patients required treatment with a statin and 22% of those did not receive a statin. Comparison of the treatment of Group 2 showed that, of 53 patients (50% of Group 2) requiring an ACE-I, 100% received it, although 15% received sub-therapeutic doses. Of 69 patients (64% of Group 2) requiring treatment with a statin 96% were prescribed a statin. Improvements in prescribing of beta-Blockers, ACE-I and statins were statistically significant. CONCLUSIONS: Prescribing improved significantly for beta-Blockers, ACE-I and statins after guideline introduction with anticipated benefits to patient outcomes.
OBJECTIVE: To validate and implement an audit tool to assess quality and appropriateness of prescribing. To compare inpatient prescribing of secondary prevention in post myocardial infarctionpatients before and after introduction of a local treatment guideline. METHOD: Descriptive, non-experimental retrospective case note review comparing patients treated before and after the implementation of a clinical guideline. MAIN OUTCOME: Comparison of quality of prescribing in two patient groups. RESULTS: Analysis of Group 1 patients showed that 41% required treatment with an angiotensin converting enzyme inhibitor (ACE-I), and 23% of those did not receive treatment, 20% of patients on ACE-I received sub-therapeutic doses. Seventy-two per cent of patients required treatment with a statin and 22% of those did not receive a statin. Comparison of the treatment of Group 2 showed that, of 53 patients (50% of Group 2) requiring an ACE-I, 100% received it, although 15% received sub-therapeutic doses. Of 69 patients (64% of Group 2) requiring treatment with a statin 96% were prescribed a statin. Improvements in prescribing of beta-Blockers, ACE-I and statins were statistically significant. CONCLUSIONS: Prescribing improved significantly for beta-Blockers, ACE-I and statins after guideline introduction with anticipated benefits to patient outcomes.