心肌梗死后普通实践中预防护理的继续和开始

F.L. Wright , S.M. Dovey, T. Lancaster, N.R. Hicks, D. Mant, H.A.W. Neil
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引用次数: 1

摘要

本研究评估了全科医生在心肌梗死一年后对患者维持医院发起的预防性治疗的程度,以及对未进行此类治疗的出院患者发起预防性治疗的程度。横断面研究对牛津郡及周边地区两家区级综合医院和97家全科医院的565名年龄小于80岁的心肌梗死一年幸存者进行了随访。我们回顾了医院出院记录和全科病例,以了解阿司匹林、β受体阻滞剂、ACE抑制剂和降脂药物的处方。急性事件发生一年后继续接受医院处方的患者人数为:阿司匹林437/466 (94%);β受体阻滞剂217/276 (79%);ace抑制剂189/218(87%)和降脂药物57/66(86%)。出院时未接受适当预防护理但接受全科处方的患者人数为:阿司匹林30/40 (75%);β受体阻滞剂49/169 (27%);ace抑制剂11/20(55%)和降脂药物81/261(31%)。总之,改善冠心病患者循证预防保健的实施是目前国家的优先事项。大多数梗死后患者都得到了高标准的管理,但在医院开始处方时达到的比率最高。在出院时实现最佳预防保健是在一般实践中实现适当长期护理的关键步骤。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Continuation and initiation of preventive care in general practice following myocardial infarction

This study assesses the extent to which general practitioners maintain hospital-initiated preventive treatment for patients one year after a myocardial infarction and initiate preventive care for patients discharged from hospital without such care. A cross-sectional study was conducted following up 565 myocardial infarction one-year survivors aged less than 80 years from two district general hospitals and 97 general practices in Oxfordshire and bordering areas. Hospital discharge records and general practice casenotes were reviewed for prescriptions of aspirin, β-blockers, ACE inhibitors, and lipid-lowering drugs. The number of patients continuing to receive hospital-initiated prescriptions one year after the acute event was: for aspirin 437/466 (94%); β-blockers 217/276 (79%); ACE-inhibitors 189/218 (87%) and lipid lowering drugs 57/66 (86%). The number of patients discharged without appropriate preventive care but receiving prescriptions initiated in general practice was: for aspirin 30/40 (75%); β-blockers 49/169 (27%); ACE-inhibitors 11/20 (55%) and lipid-lowering drugs 81/261 (31%). In conclusion, improving the implementation of evidence-based preventive care for patients with coronary heart disease is now a national priority. Most post-infarction patients were managed to a high standard, but the highest rates were attained when prescribing was initiated in hospital. Achieving optimal preventive care at hospital discharge is a crucial step in achieving appropriate long-term care in general practice.

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