Skip to main content
Log in

Use of Discharge-Worksheet Enhances Compliance with Evidence-Based Myocardial Infarction Care

  • Published:
Journal of Thrombosis and Thrombolysis Aims and scope Submit manuscript

Abstract

Background: Prior studies demonstrate that effective secondary prevention therapies are underutilized in patients with myocardial infarction (MI) at hospital discharge. At a US tertiary center, we developed and encouraged providers to complete a simple “Acute MI Discharge Worksheet” (MIDW) designed to educate patients, prompt caregivers, and provide chart documentation regarding evidence-based therapies post-MI.

Methods and Results: The MIDW was introduced in May of 2000 with use encouraged in all surviving patients with MI. We calculated a patient discharge score by summing the number of quality indicators (aspirin use, beta-blocker use, ACE-inhibitor use, smoking cessation, lipid-lowering therapy, cardiac rehabilitation referral) and compared documentation of quality indicators at discharge between patients without (Group I, n = 65) and with (Group II, n = 60) the MIDW. Group II was subdivided into those with an incomplete worksheet (Group IIa, n = 26), and those with a completed worksheet (Group IIb, n = 34). Greater documentation of secondary prevention indicators occurred in patients with incomplete and completed discharge forms present. Mean Discharge scores were significantly higher for Group II vs. Group I (4.98 vs. 3.88, p < 0.0001), and Group IIb vs. Group IIa, (5.47 vs. 4.35, p < 0.001).

Conclusion: A simple “Acute MI Discharge Worksheet” was associated with better adherence and documentation of evidence-based post MI care and be a useful component to improve post MI care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease. The Lancet1994;344: 1383–1389.

    Google Scholar 

  2. ISIS-2 Collaborative Group. Second International Study of Infarct Survival. Randomized trial of intravenous streptokinase, oral aspirin, both or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. The Lancet1988;2: 349–359.

    Google Scholar 

  3. Hennikens C, Albert C, Godfried S, Gaziano M, Burning J. Adjunctive drug therapy of acute myocardial infarction— evidence from clinical trials. The New England Journal of Medicine1996;335: 1660–1667.

    Google Scholar 

  4. Oldridge NB. Cardiac rehabilation after myocardial infarction. JAMA1988;260: 945–950.

    Google Scholar 

  5. Jencks S, Cuerdon T, Burwen D, Fleming B, Housck P. Quality of medical care delivered to medicare beneficiaries. Journal of the American Medical Association2000;284: 1670–1676.

    Google Scholar 

  6. Ryan TJ, Anderson JL, Antman EM. ACC/AHA guidelines for the management of patients with acute myocardial infarction. A report of the American College of Cardiology/ American Heart Association Task Force on practice guidelines. Journal of the American College of Cardiology1996;28: 1328–1342.

    Google Scholar 

  7. Ellerbeck E, Jencks S, Radford M, Kresowik T, Craig A, Gold J. Quality of care for medicare patients with acute myocardial infarction. JAMA1995;273: 1509–1514.

    Google Scholar 

  8. Singh P, Lopez-Candales A. Suboptimal use of adjunctive pharmacologic strategies in survivors of an acute myocardial infarction: a survey from the Western New York Region. J Invest Med1998;46: 290.

    Google Scholar 

  9. Mehta R, Das S, Tsai T. Quality improvement initiative and its impact on the management of patients with acute myocardial infarction. Arch Intern Med2000;160: 3057–3062.

    Google Scholar 

  10. Euroaspire Group I and II. Clinical reality of coronary prevention guidelines: a comparison of Euroaspire I and II in nine countries. The Lancet2001;357: 995–1001.

    Google Scholar 

  11. Marciniak T, Ellerbeck E, Radford M, et al. Improving the quality of care for medicare patients with acute myocardial infarction. JAMA1998;279: 1351–1357.

    Google Scholar 

  12. Axtell S, Ludwig E, Lopez-Candales A. Intervention to improve adherence to ACC/AHA recommentded adjunctive medications for the management of patients with acute myocardical infarction. Clin Cardiol2001;24: 114–118.

    Google Scholar 

  13. Lee T, Pearson S, Johnson PA, et al. Failure of information as an intervention to modify clinical management. A time-series trial in patients with acute chest pain. Ann Intern Med1994;122: 434–437.

    Google Scholar 

  14. Mehta R, Eagle K, Riba A, Winston S, Sobotka P, Montoye C. Improving quality of care for acute myocardial infarction. The Guidelines Applied in Practice (GAP) Initiative. JAMA2002;287: 1269–1276.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nori, D., Johnson, J., Kapke, A. et al. Use of Discharge-Worksheet Enhances Compliance with Evidence-Based Myocardial Infarction Care. J Thromb Thrombolysis 14, 43–49 (2002). https://doi.org/10.1023/A:1022014321328

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1022014321328

Navigation