AIMS: To assess the level of evidence-based drug prescribing for acute coronary syndrome (ACS) at discharge from Western Australian (WA) hospitals and determine predictors of such prescribing in Aboriginal and non-Aboriginal patients. METHODS:All Aboriginal (2002-2004) and a random sample of non-Aboriginal (2003) hospital admissions with a principal diagnosis of ACS were extracted from the WA Hospital Morbidity Data Collection of WA Data Linkage System. Clinical information, history of co-morbidities and drugs were collected from medical notes by trained data collectors. Evidence-based prescribing (EBP) was defined as prescribing of aspirin, statin and beta-blocker or angiotensin-converting enzyme inhibitor/angiotensin II antagonist. RESULTS: Records for 1717 ACS patients discharged alive from hospitals were reviewed. The majority of patients (71%) had EBP, and there was no significant difference between Aboriginal and non-Aboriginal patients (70% vs 71%, P = 0.36). Conversely, a significantly higher proportion of Aboriginal patients had none of the drugs prescribed compared with non-Aboriginal patients (11% vs 7%, P < 0.01). EBP for ACS was independently associated with male sex (odds ratio (OR) 1.63, 95% confidence interval (CI) 1.26-2.11), previous admission for ACS (OR 1.83, 95% CI 1.39-2.42) and diabetes (OR 1.36, 95% CI 1.04-1.79). However, ACS patients living in regional and remote areas, attending district or private hospitals, or with a history of chronic obstructive pulmonary disease were significantly less likely to have ACS drugs prescribed at discharge. CONCLUSIONS: Opportunity exists to improve prescribing of recommended drugs for ACS patients at discharge from WA hospitals in both Aboriginal and non-Aboriginal patients. Attention regarding pharmaceutical management post-ACS is particularly required for patients from rural and remote areas, and those attending district and private hospitals.
RCT Entities:
AIMS: To assess the level of evidence-based drug prescribing for acute coronary syndrome (ACS) at discharge from Western Australian (WA) hospitals and determine predictors of such prescribing in Aboriginal and non-Aboriginalpatients. METHODS: All Aboriginal (2002-2004) and a random sample of non-Aboriginal (2003) hospital admissions with a principal diagnosis of ACS were extracted from the WA Hospital Morbidity Data Collection of WA Data Linkage System. Clinical information, history of co-morbidities and drugs were collected from medical notes by trained data collectors. Evidence-based prescribing (EBP) was defined as prescribing of aspirin, statin and beta-blocker or angiotensin-converting enzyme inhibitor/angiotensin II antagonist. RESULTS: Records for 1717 ACS patients discharged alive from hospitals were reviewed. The majority of patients (71%) had EBP, and there was no significant difference between Aboriginal and non-Aboriginalpatients (70% vs 71%, P = 0.36). Conversely, a significantly higher proportion of Aboriginal patients had none of the drugs prescribed compared with non-Aboriginalpatients (11% vs 7%, P < 0.01). EBP for ACS was independently associated with male sex (odds ratio (OR) 1.63, 95% confidence interval (CI) 1.26-2.11), previous admission for ACS (OR 1.83, 95% CI 1.39-2.42) and diabetes (OR 1.36, 95% CI 1.04-1.79). However, ACS patients living in regional and remote areas, attending district or private hospitals, or with a history of chronic obstructive pulmonary disease were significantly less likely to have ACS drugs prescribed at discharge. CONCLUSIONS: Opportunity exists to improve prescribing of recommended drugs for ACS patients at discharge from WA hospitals in both Aboriginal and non-Aboriginalpatients. Attention regarding pharmaceutical management post-ACS is particularly required for patients from rural and remote areas, and those attending district and private hospitals.
Authors: Tiew-Hwa Katherine Teng; Judith M Katzenellenbogen; Joseph Hung; Matthew Knuiman; Frank M Sanfilippo; Elizabeth Geelhoed; Michael Hobbs; Sandra C Thompson Journal: BMJ Open Date: 2014-05-02 Impact factor: 2.692
Authors: Anthony S Gunnell; Matthew W Knuiman; Elizabeth Geelhoed; Michael S T Hobbs; Judith M Katzenellenbogen; Joseph Hung; Jamie M Rankin; Lee Nedkoff; Thomas G Briffa; Michael Ortiz; Malcolm Gillies; Anne Cordingley; Mitch Messer; Christian Gardner; Derrick Lopez; Emily Atkins; Qun Mai; Frank M Sanfilippo Journal: BMJ Open Date: 2014-09-18 Impact factor: 2.692
Authors: Tiew-Hwa Katherine Teng; Judith M Katzenellenbogen; Joseph Hung; Matthew Knuiman; Frank M Sanfilippo; Elizabeth Geelhoed; Dawn Bessarab; Michael Hobbs; Sandra C Thompson Journal: Int J Equity Health Date: 2015-08-12
Authors: Pamela J Bradshaw; Judith M Katzenellenbogen; Frank M Sanfilippo; Michael S T Hobbs; Peter L Thompson; Sandra C Thompson Journal: BMC Cardiovasc Disord Date: 2015-11-16 Impact factor: 2.298