Evidence map›Paper›PMID 29326185›Full record

SynthesisBMJ open2018

Enhancing prescribing of guideline-recommended medications for ischaemic heart diseases: a systematic review and meta-analysis of interventions targeted at healthcare professionals.

Thang Nguyen, Hoa Q Nguyen, Niken N Widyakusuma, Thao H Nguyen, Tam T Pham, Katja Taxis

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. Review
  6. Implementation of clinical audit to improve adherence to guideline-recommended therapy in acute coronary syndrome.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Thang NguyenDepartment of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.ORCID 0000-0001-7799-4523
Hoa Q NguyenDepartment of Clinical Pharmacy, Faculty of Pharmacy, University of Medicine and Pharmacy, Ho Chi Minh, Vietnam.
Niken N WidyakusumaDivision of Management and Community Pharmacy, Faculty of Pharmacy, Gadjah Mada University, Yogyakarta, Indonesia.
Thao H NguyenDepartment of Clinical Pharmacy, Faculty of Pharmacy, University of Medicine and Pharmacy, Ho Chi Minh, Vietnam.
Tam T PhamFaculty of Public Health, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.
Katja TaxisGroningen Research Institute of Pharmacy, Unit of PharmacoTherapy, Epidemiology & Economics, University of Groningen, Groningen, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesIschaemic heart diseases (IHDs) are a leading cause of death worldwide. Although prescribing according to guidelines improves health outcomes, it remains suboptimal. We determined whether interventions targeted at healthcare professionals are effective to enhance prescribing and health outcomes in patients with IHDs.

methodsWe systematically searched PubMed and EMBASE for studies published between 1 January 2000 and 31 August 2017. We included original studies of interventions targeted at healthcare professionals to enhance prescribing guideline-recommended medications for IHDs. We only included randomised controlled trials (RCTs). Main outcomes were the proportion of eligible patients receiving guideline-recommended medications, the proportion of patients achieving target blood pressure and target low-density lipoprotein-cholesterol (LDL-C)/cholesterol level and mortality rate. Meta-analyses were performed using the inverse-variance method and the random effects model. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach.

resultsWe included 13 studies, 4 RCTs (1869 patients) and 9 cluster RCTs (15 224 patients). 11 out of 13 studies were performed in North America and Europe. Interventions were of organisational or professional nature. The interventions significantly enhanced prescribing of statins/lipid-lowering agents (OR 1.23; 95% CI 1.07 to 1.42, P=0.004), but not other medications (aspirin/antiplatelet agents, beta-blockers, ACE inhibitors/angiotensin II receptor blockers and the composite of medications). There was no significant association between the interventions and improved health outcomes (target LDL-C and mortality) except for target blood pressure (OR 1.46; 95% CI 1.11 to 1.93; P=0.008). The evidence was of moderate or high quality for all outcomes.

conclusionsOrganisational and professional interventions improved prescribing of statins/lipid-lowering agents and target blood pressure in patients with IHDs but there was little evidence of change in other outcomes. PROSPERO REGISTRATION NUMBER: CRD42016039188.

Indexed as

Delivery of Health CareDrug PrescriptionsGuideline AdherencePractice Patterns, Physicians'Adrenergic beta-AntagonistsAgedAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsBlood PressureCholesterolFemaleHealth PersonnelHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedAdrenergic beta-AntagonistsAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsCholesterolHydroxymethylglutaryl-CoA Reductase InhibitorsPlatelet Aggregation Inhibitorsguideline adherenceischaemic heart diseasepreventive medicinequality In health care

Identifiers

PMID29326185
PMCPMC5988110

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.