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Evidence-Based Drugs Gaining Use After Heart Attack

Accompanying study examines factors linked to use of such drugs in elderly after discharge

WEDNESDAY, Oct. 22 (HealthDay News) -- The use of statins, β-blockers and angiotensin-modifying drugs rose steeply in older patients with myocardial infarction from 1992 to 2005, and many patient, physician and hospital characteristics influence the use of evidence-based drug therapies after such patients are discharged, according to the results of two studies published in the Oct. 21 issue of CMAJ, the Canadian Medical Association Journal.

Peter C. Austin, Ph.D., of the Institute for Clinical Evaluative Sciences in Toronto, Ontario, Canada, and colleagues analyzed data from 132,778 patients aged 65 and older with myocardial infarction who were discharged between 1992 and 2005. Between these years, the percentage of patients who filled a prescription for a β-blocker increased from 42.6 to 78.1 percent, for an angiotensin-modifying drug increased from 42 to 78.4 percent, and for a statin increased from 4.2 to 79.2 percent.

In the other study, the same authors analyzed data from 8,706 patients, also 65 and older, who were discharged from hospitals in a period during 2005 and 2006 with a diagnosis of myocardial infarction. Factors associated with lower post-discharge use of medications such as β-blockers, angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers and statins included increasing patient age, having a non-cardiologist as the attending physician, and having an attending physician with at least 29 years of experience, compared to someone who had graduated within the past 15 years, the report indicates.

"Our study suggests that there is a need to develop more effective mechanisms for knowledge translation to improve the clinical practice of non-cardiology specialists and of physicians who have been in clinical practice for a long time. We speculate that the development and widespread dissemination of standardized discharge orders for patients with myocardial infarction could improve the delivery of evidence-based drug therapies," the authors conclude in the second study.

One of the co-authors is the chief scientific officer of INTERxVENT Canada.

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