Acute Coronary Syndromes Clinical Trial
Official title:
Knowledge Translation to Promote Evidence-based Medical Therapy in Acute Coronary Syndromes
Cluster randomized open-label experimental study multi-center of 24 hospitals to either knowledge translation vs usual care to improve care of patents hospitalized for acute coronary syndromes.
The AMI-OPTIMA study was a cluster randomized controlled trial of 24 hospitals to one-year
knowledge translation (KT) vs usual care. Prior to randomization, we reviewed charts of 100
consecutive acute coronary syndromes (ACS) patients at each participating hospital in 2009.
During one year, hospitals randomized to KT completed: 1) revision of the most recent
American Heart Association Guidelines of ACS management, 2) focus groups to identify and
solve local care gaps, and 3)local champion team to promote evidence-based medical therapy
(EBMT). At the end of 12-month of KT/usual care, we reviewed discharge prescriptions of 100
consecutive ACS patients at each participating hospital (year 2012).
EBMT was pre-defined as in-hospital anticoagulation and discharge prescription of dual
anti-platelets, beta-blockers, statins, and angiotensin pathway modulating agents (for
patients with impaired left ventricular systolic function). Refusal, impaired cognitive
function, allergy or intolerance of patients to any of EBMT were considered valid reasons
for withholding EBMT.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label
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