TY - JOUR
T1 - Impact of medical consultation frequency on risk factors and medications 6 months after acute coronary syndrome
AU - Hyun, K.
AU - Brieger, D.
AU - Chow, C.K.
AU - Ilton, M.
AU - Amos, D.
AU - Alford, K.
AU - Roberts-Thomson, P.
AU - Santo, K.
AU - Atkins, E.R.
AU - Redfern, J.
N1 - Publisher Copyright:
© 2016 Harris.
PY - 2016/1
Y1 - 2016/1
N2 - Objective: Initiatives that support primary care to better enable delivery of optimal prevention services are of great importance. The purpose of this study was to examine the frequency of medical consultations by patients with acute coronary syndrome (ACS) in the 6 months after hospital discharge and to determine whether the frequency of visits was associated with differences in lifestyle, clinical measures and medication prescription. Methods:We conducted a retrospective subgroup analysis of data collected in the Cooperative National Registry of Acute Coronary Care, Guideline Adherence and Clinical Events (CONCORDANCE), which is an ongoing (prospective) clinical initiative providing continuous real-time reporting on the clinical characteristics, management and outcomes of patients admitted to Australian hospitals with ACS. We compared clinical measures, medications, smoking status and receipt of cardiac rehabilitation with frequency of medical consultations 6 months after hospital discharge. Results: Patients with ACS visited their general practitioner (GP) a mean of
4.4 (± 3.8) times and their cardiologist 1.2 (± 0.9) times in the 6-month period
after their index admission. Patients who saw a GP in the 6-month period
had significantly higher rates of participation in cardiac rehabilitation, receipt
of dietary advice and prescription of cardioprotective medications. Factors
associated with increased frequency of GP visits were older age groups
(oldest fourth vs youngest fourth incidence rate ratio (IRR) 1.08; 95% CI 1.01,
1.14), being female (male vs female IRR 0.83; 95% CI 0.80, 0.86), diagnosis
of ST-segment elevation myocardial infarction (STEMI) (STEMI vs non-STEMI
IRR 1.08; 95% CI 1.04, 1.13; STEMI vs unstable angina IRR 1.01; 95% CI
0.95, 1.06), being a current smoker (IRR 1.09; 95% CI 1.05, 1.15), history
of cardiovascular disease (IRR 1.06; 95% CI 1.01, 1.12), history of diabetes
(IRR 1.25; 95% CI 1.21, 1.31), in-hospital inpatient revascularisation (IRR 0.95; 95% CI 0.91, 0.99), receipt of cardiac rehabilitation referral (IRR 0.93; 95% CI
0.89, 0.97), and discharged on four or more out of five indicated medications
(IRR 1.04; 95% CI 1.00, 1.08).Conclusion: The majority of ACS survivors in this study saw their GP frequently and their cardiologist at least once during the 6 months after index admission. Seizing these opportunities to engage, manage and support patients is important for strengthening prevention in primary care.
AB - Objective: Initiatives that support primary care to better enable delivery of optimal prevention services are of great importance. The purpose of this study was to examine the frequency of medical consultations by patients with acute coronary syndrome (ACS) in the 6 months after hospital discharge and to determine whether the frequency of visits was associated with differences in lifestyle, clinical measures and medication prescription. Methods:We conducted a retrospective subgroup analysis of data collected in the Cooperative National Registry of Acute Coronary Care, Guideline Adherence and Clinical Events (CONCORDANCE), which is an ongoing (prospective) clinical initiative providing continuous real-time reporting on the clinical characteristics, management and outcomes of patients admitted to Australian hospitals with ACS. We compared clinical measures, medications, smoking status and receipt of cardiac rehabilitation with frequency of medical consultations 6 months after hospital discharge. Results: Patients with ACS visited their general practitioner (GP) a mean of
4.4 (± 3.8) times and their cardiologist 1.2 (± 0.9) times in the 6-month period
after their index admission. Patients who saw a GP in the 6-month period
had significantly higher rates of participation in cardiac rehabilitation, receipt
of dietary advice and prescription of cardioprotective medications. Factors
associated with increased frequency of GP visits were older age groups
(oldest fourth vs youngest fourth incidence rate ratio (IRR) 1.08; 95% CI 1.01,
1.14), being female (male vs female IRR 0.83; 95% CI 0.80, 0.86), diagnosis
of ST-segment elevation myocardial infarction (STEMI) (STEMI vs non-STEMI
IRR 1.08; 95% CI 1.04, 1.13; STEMI vs unstable angina IRR 1.01; 95% CI
0.95, 1.06), being a current smoker (IRR 1.09; 95% CI 1.05, 1.15), history
of cardiovascular disease (IRR 1.06; 95% CI 1.01, 1.12), history of diabetes
(IRR 1.25; 95% CI 1.21, 1.31), in-hospital inpatient revascularisation (IRR 0.95; 95% CI 0.91, 0.99), receipt of cardiac rehabilitation referral (IRR 0.93; 95% CI
0.89, 0.97), and discharged on four or more out of five indicated medications
(IRR 1.04; 95% CI 1.00, 1.08).Conclusion: The majority of ACS survivors in this study saw their GP frequently and their cardiologist at least once during the 6 months after index admission. Seizing these opportunities to engage, manage and support patients is important for strengthening prevention in primary care.
UR - http://www.scopus.com/inward/record.url?scp=84994068572&partnerID=8YFLogxK
U2 - 10.17061/phrp2611606
DO - 10.17061/phrp2611606
M3 - Article
SN - 2204-2091
VL - 26
SP - 1
EP - 8
JO - Public Health Research and Practice
JF - Public Health Research and Practice
IS - 1
M1 - e2611606
ER -