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
References
Feb 1, 1982·The American Journal of Medicine·H SacksH Smith
Jun 4, 1999·BMJ : British Medical Journal·G FederM Spence
Feb 11, 2000·Archives of Internal Medicine·E A BalasG D Brown
Sep 16, 2000·JAMA : the Journal of the American Medical Association·J G DemakisW G Henderson
Apr 11, 2001·Lancet·UNKNOWN EUROASPIRE I and II Group; European Action on Secondary Prevention by Intervention to Reduce Events
May 18, 2001·Lancet·M EcclesS Bond
Oct 26, 2002·BMJ : British Medical Journal·Martin EcclesIan Purves
Dec 23, 2003·Journal of General Internal Medicine·William M TierneyFredric D Wolinsky
Feb 13, 2004·Health Technology Assessment : HTA·J M GrimshawC Donaldson
May 18, 2004·Journal of the American College of Cardiology·Sumit R MajumdarCurt D Furberg
Sep 24, 2004·The American Journal of Medicine·Edward GuadagnoliBarbara J McNeil
Apr 2, 2005·Journal of the American Medical Informatics Association : JAMIA·Thomas D SequistDavid W Bates
Sep 1, 2005·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Finlay A McAlisterUNKNOWN Decision Aid in Atrial Fibrillation (DAAFI) Investigators
Jan 13, 2006·Circulation·L Kristin NewbyRobert M Califf
Jan 13, 2006·JAMA : the Journal of the American Medical Association·Deepak L BhattUNKNOWN REACH Registry Investigators
Jan 21, 2006·Journal of General Internal Medicine·William T LesterHenry C Chueh
Jun 20, 2006·Lancet·Ruth E ThomasJeremy Grimshaw
Sep 15, 2006·The Canadian Journal of Cardiology·Ruth McPherson Canadian Cardiovascular Society
Dec 19, 2006·American Heart Journal·Sumit R MajumdarFinlay A McAlister
May 30, 2007·Archives of Internal Medicine·Finlay A McAlisterUNKNOWN Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) Investigators
Jun 8, 2007·The New England Journal of Medicine·Earl S FordSimon Capewell
Aug 10, 2007·The New England Journal of Medicine·Andrew D AuerbachKaveh G Shojania
Jan 4, 2008·Circulation·Jacobus T van WykJohan van der Lei
Feb 27, 2008·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Sumit R MajumdarBrian H Rowe
Feb 27, 2008·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Kiranbir JosanFinlay A McAlister
Jun 21, 2008·The New England Journal of Medicine·Catherine M DesRochesDavid Blumenthal
Nov 26, 2008·Archives of Internal Medicine·Donna L McLeanUNKNOWN SCRIP-HTN Investigators
Citations
Sep 26, 2013·BMC Health Services Research·Raj S PadwalSumit R Majumdar
Apr 14, 2010·Implementation Science : IS·Finlay A McAlisterAshfaq Shuaib
Jun 12, 2012·Implementation Science : IS·Noah M IversMadhu K Natarajan
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
Dec 25, 2013·Family Practice·Susanne UnverzagtAndreas Klement
Feb 1, 2011·Revista española de cardiología·José A BarrabésAntonio Fernández-Ortiz
Nov 7, 2015·American Heart Journal·Jon-David SchwalmJeremy M Grimshaw
Oct 14, 2014·The Canadian Journal of Cardiology·Finlay A McAlisterTodd Anderson
Feb 24, 2015·PloS One·Jing HuSiyan Zhan
Oct 25, 2014·PloS One·Susanne UnverzagtAndreas Klement
Dec 9, 2014·PloS One·Sabine WittBjörn Stollenwerk
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
Jul 7, 2017·The Cochrane Database of Systematic Reviews·Chantal ArditiBernard Burnand
Dec 21, 2019·The Cochrane Database of Systematic Reviews·Tomas PantojaJaviera Leniz Martelli
Jul 3, 2020·Implementation Science : IS·Sze Lin YoongLuke Wolfenden
Sep 4, 2012·The American Journal of Medicine·Sumit R MajumdarBrian H Rowe
Apr 15, 2021·Implementation Science : IS·Laney K JonesMichael R Gionfriddo
Aug 18, 2021·CJC Open·Shaun ShepherdJ D Schwalm
Oct 26, 2021·The Cochrane Database of Systematic Reviews·Nicola LindsonSophia Papadakis