Current discharge management of acute coronary syndromes: Baseline results from a national quality improvement initiative

Wai, Angela, Pulver, Lisa K., Oliver, Kate and Thompson, Angus (2012) Current discharge management of acute coronary syndromes: Baseline results from a national quality improvement initiative. Internal Medicine Journal, 42 5: e53-e59. doi:10.1111/j.1445-5994.2010.02308.x

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Author Wai, Angela
Pulver, Lisa K.
Oliver, Kate
Thompson, Angus
Title Current discharge management of acute coronary syndromes: Baseline results from a national quality improvement initiative
Journal name Internal Medicine Journal   Check publisher's open access policy
ISSN 1444-0903
Publication date 2012-05
Year available 2010
Sub-type Article (original research)
DOI 10.1111/j.1445-5994.2010.02308.x
Volume 42
Issue 5
Start page e53
End page e59
Total pages 7
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing Asia
Collection year 2011
Language eng
Formatted abstract
Evidence–practice gaps exist in the continuum of care for patients with acute coronary syndromes (ACS), particularly at hospital discharge.

To describe the methodology and baseline results of the Discharge Management of Acute Coronary Syndromes (DMACS) project, focusing on the prescription of guideline-recommended medications, referral to cardiac rehabilitation and communication between the hospital, patient and their primary healthcare professionals.


DMACS employed Drug Use Evaluation methodology involving data collection, evaluation and feedback, and targeted educational interventions. Adult patients with ACS discharged during a 4-month period were eligible to participate. Data was collected (maximum 50 patients) at each site via an inpatient medical record review, a GP postal/fax survey conducted 14 days post-discharge and a patient telephone survey 3 – months post-discharge.

Forty-nine hospitals participated in the audit recruiting 1545 patients. At discharge 57% of patients were prescribed a combination of antiplatelet agent(s), beta blocker, statin and angiotensin-converting enzyme inhibitor and/or angiotensin-II antagonist. At 3-months post-discharge, 48% of patients reported using the same combination. 67% of patients recalled being referred to cardiac rehabilitation; of these 33% had completed the program. 83% of patients had a documented ACS management plan at discharge. Of these 90% included a medication list, 56% a chest pain action plan and 54% risk factor modification advice. 65% of GPs rated the quality of information received in the discharge summary as ‘very good’ to ‘excellent’.

The findings of our baseline audit showed that despite the robust evidence base and availability of national guidelines, the management of patients with ACS can be improved. These findings will inform a multi-faceted intervention strategy to improve adherence to guidelines for the discharge management of patients with ACS.
Keyword Acute coronary syndromes
Patient discharge
Drug utilizationr eview evidence-based medicine
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Accepted Article (Accepted, unedited articles published online 14 July, 2010 for future issues)

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Pharmacy Publications
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Citation counts: TR Web of Science Citation Count  Cited 9 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 7 times in Scopus Article | Citations
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Created: Mon, 24 Jan 2011, 14:53:01 EST by Lisa Pulver on behalf of School of Pharmacy