PMID: 15381518Sep 24, 2004Paper

Improvements in 1-year cardiovascular clinical outcomes associated with a hospital-based discharge medication program

Annals of Internal Medicine
Jason M LappéJeffrey L Anderson

Abstract

Despite recent advances in the treatment and prevention of cardiovascular disease, a treatment gap for secondary prevention medications still exists. To develop and implement a program ensuring appropriate prescription of aspirin, statins, beta-blockers, angiotensin-converting enzyme inhibitors, and warfarin at hospital discharge. A nonrandomized before-after study comparing patients hospitalized before (1996-1998) and after (1999-2002) implementation of a discharge medication program (DMP). Patients were followed for up to 1 year. The 10 largest hospitals in the Utah-based Intermountain Health Care system. In the pre-DMP and DMP time periods, 26,000 and 31,465 patients, respectively, were admitted to cardiovascular services (n = 57,465). Prescription of indicated medications at hospital discharge; postdischarge death or readmission. By 1 year, the rate of prescription of each medication increased significantly to more than 90% (P < 0.001); this rate was sustained. At 1 year, unadjusted absolute event rates for readmission and death, respectively, were 210 per 1000 person-years and 96 per 1000 person-years before DMP implementation and 191 per 1000 person-years and 70 per 1000 person-years afterward. Relative risk for death and...Continue Reading

Citations

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