Acute Coronary Syndromes, Coronary Artery Disease
Conditions
Keywords
non-ST elevation acute coronary syndrome, educational intervention, evidence based practice, guidelines
Brief summary
This is a multi-centre UK study designed to evaluate if an educational intervention programme delivered to health care professionals can improve the use of evidence based treatments in the management of patients admitted to hospital with non-ST elevation Acute Coronary Syndrome. A total of 38 centres participated, half received the educational intervention. Patients were followed to hospital discharge. Patients were followed up at 6 months. Longer term follow up through the Office Of National Statistics will be performed.
Detailed description
This is a multi-centre UK study designed to evaluate if an educational intervention programme delivered to health care professionals can improve the use of evidence based treatments in the management of patients admitted to hospital with non-ST elevation Acute Coronary Syndrome. A total of 38 centres participated. A cluster randomised method was used and half of centres received the educational intervention. Patients were followed to hospital discharge. Patients were followed up at 6 months and longer term follow up for mortality will be performed through the national databases.
Interventions
BEHAVIORALEducational intervention programme
Sponsors
Sanofi
Bristol-Myers Squibb
Royal Brompton & Harefield NHS Foundation Trust
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
All patients admitted to the hospital (either through casualty or directly to the wards), with a good clinical history of an acute coronary syndrome with one or more of the following: 1. Ischaemic changes on the admission ECG (including patients with bundle branch block) 2. Elevated Troponin or cardiac enzymes on admission 3. Normal ECGs but with evidence of pre-existing coronary artery disease i.e., evidence of a prior history of MI, coronary revascularisation, coronary angiography demonstrating the presence of significant coronary stenosis or a stress test demonstrating ischaemia (treadmill, echo or nuclear scan) Written informed consent
Exclusion criteria
1. Patients with persistent ST elevation \>1mm in two or more contiguous leads on the ECG. 2. Patients treated with thrombolytic therapy, or for whom thrombolytic therapy was considered on admission.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Adherence to the educational programme measured by the frequency of use of the evidence based treatments: Aspirin, Heparin, Clopidogrel, Beta blockers, Statins. | — |
Secondary
| Measure | Time frame |
|---|---|
| Use of other treatments | — |
| Counselling for lifestyle changes | — |
| Referral to smoking cessation clinics | — |
| Comparison of investigations and tests | — |
| Compliance to treatment at 6 months | — |
| Comparison of clinical events at 6 months | — |
| Cardiac rehabilitation | — |
Countries
United Kingdom
Outcome results
None listed