The Enhancing Secondary Prevention in Coronary Artery Disease trial.

CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne
Finlay A McAlisterJeremy M Grimshaw

Abstract

Proven efficacious therapies are sometimes underused in patients with chronic cardiac conditions, resulting in suboptimal outcomes. We evaluated whether evidence summaries, which were either unsigned or signed by local opinion leaders, improved the quality of secondary prevention care delivered by primary care physicians of patients with coronary artery disease. We performed a randomized trial, clustered at the level of the primary care physician, with 3 study arms: control, unsigned statements or opinion leader statements. The statements were faxed to primary care physicians of adults with coronary artery disease at the time of elective cardiac catheterization. The primary outcome was improvement in statin management (initiation or dose increase) 6 months after catheterization. We enrolled 480 adults from 252 practices. Although statin use was high at baseline (n=316 [66%]), most patients were taking a low dose (mean 32% of the guideline-recommended dose), and their low-density lipoprotein (LDL) cholesterol levels were elevated (mean 3.09 mmol/L). Six months after catheterization, statin management had improved in 79 of 157 patients (50%) in the control arm, 85 of 158 (54%) patients in the unsigned statement group (adjusted od...Continue Reading

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Citations

Feb 10, 2010·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Noah M Ivers
Feb 22, 2012·Clinical Journal of the American Society of Nephrology : CJASN·Braden MannsUNKNOWN Alberta Kidney Disease Network
Apr 16, 2014·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Finlay A McAlisterAshfaq Shuaib
Feb 1, 2011·Revista española de cardiología·José A BarrabésAntonio Fernández-Ortiz
Sep 14, 2012·The Cochrane Database of Systematic Reviews·Lakshmi MurthySharon E Straus
Aug 13, 2011·The Cochrane Database of Systematic Reviews·Gerd FlodgrenMartin P Eccles
Jun 25, 2019·The Cochrane Database of Systematic Reviews·Gerd FlodgrenJeremy M Grimshaw
Dec 21, 2019·The Cochrane Database of Systematic Reviews·Tomas PantojaJaviera Leniz Martelli
Sep 4, 2012·The American Journal of Medicine·Sumit R MajumdarBrian H Rowe
Oct 26, 2021·The Cochrane Database of Systematic Reviews·Nicola LindsonSophia Papadakis

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