Heart attack help: Program helps boost use of key therapies in hospitals

U-M program for doctors, nurses & patients boosts use of key proven therapies in heart attack victims

ANN ARBOR, MI - Heart experts know a lot about what heart attack patients need: aspirin and clot-busters in the emergency room; drugs like ACE inhibitors, beta blockers and cholesterol fighters; tests and procedures like angiography; and advice on diet, exercise and smoking.

But at many hospitals, there's a troubling gap between what experts say is best, and what patients actually get - mostly because there's been no consistent way to make sure the health care team gives every patient all the proven treatments recommended by national guidelines.

Now, University of Michigan Health System heart specialists are reporting success with a way to close that gap between knowledge and practice. Their solution: a program that targets doctors, nurses and patients alike with care standards, educational materials, reminders, and more.

This week, the U-M team published the encouraging results of their own test of the program, and presented early indications that such a strategy is producing similar results at 10 southeast Michigan hospitals. The paper was in the Nov. 13 Archives of Internal Medicine, and the presentation was at the American Heart Association's Scientific Sessions in New Orleans.

Among the findings: 98 percent of eligible U-M heart attack patients in the study got clot-busting drugs in the emergency room, most in the first hour. Over 94 percent were put on beta blockers, and 90 percent got ACE inhibitors - a jump from 65 percent and 45 percent, respectively, in 1995. The use of cholesterol-lowering drugs went from 38 percent to 67 percent. Ninety-four percent of smokers were counseled about stopping, and 96 percent got advice about diet.

Similar numbers, showing 90 percent or higher use for four of six key therapies, are emerging from preliminary findings at 10 other hospitals now using a similar program.

"The guidel

Contact: Kara Gavin
University of Michigan Health System

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