Outpatient physicians’ compliance with clinical practice guidelines for the prevention of recurrent myocardial infarction

Objective. To assess outpatient physicians’ compliance with clinical practice guidelines during prevention of recurrent myocardial infarction (MI). Materials and methods. A cross-sectional study was conducted in an outpatient clinic branch in Moscow. A total of 126 records of outpatients diagnosed with MI in the past 3 years (2012-2015) were analyzed. The compliance of drug therapy prescriptions with federal clinical practice guidelines was analyzed in patients with a history of recurrent MI developing 28 days after previous stroke and in those with no history of recurrent MIs. Results. The morbidity and mortality from coronary heart disease and acute MI remain at a high level in the Russian Federation. In the past 6 years, the mortality from recurrent MI has been more than twice that from single MI. An analysis of drug therapy prescriptions for patients with MI established their inconsistency with clinical practice guidelines for the prevention of the disease, as well as the low-level diagnosis of recurrent MI. An inadequate frequency of evidence IA drug uses and a very low frequency of percutaneous coronary intervention were identified. Conclusion. An inconsistency between invasive and drug therapy policies in the prevention of recurrent MI and a low-level diagnosis of the latter suggest that the outpatient physicians show a low compliance with the clinical practice guidelines for the prevention of MI.

myocardial infarction, recurrent myocardial infarction, evidence-based medicine, clinical practice guidelines, pharmacoepidemiology