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Application of the MAT-CHDSP to assess guideline adherence and therapy goal achievement in secondary prevention of coronary heart disease after percutaneous coronary intervention

  • Pharmacoepidemiology and Prescription
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Abstract

Purpose

Numerous studies have documented suboptimal adherence to guideline recommendations in secondary prevention of coronary heart disease (CHDSP). Clinical practice guidelines (CPGs) are continuously developed to define appropriate patient care, aiming to reduce risk of morbidity and death. The Medication Assessment Tool for CHDSP (MAT-CHDSP) was developed to assess adherence to CPGs concerning medication therapy and follow-up of patients with CHDSP. The aim of this study was to explore whether the MAT-CHDSP could be applied retrospectively to assess guideline adherence and therapy goal achievement in secondary prevention of CHD.

Methods

We collected data from electronic medical records of all patients who underwent percutaneous coronary intervention with stent implantation from January to March 2008 (n = 300) and applied the MAT-CHDSP. We measured time for data collection and MAT application and tested reproducibility by calculating Cohen’s kappa (κ) value for inter and intraobserver agreement.

Results

A total of 247 MAT applications were analyzed, showing overall applicability of 66 % of the 4,446 MAT-CHDSP criteria and a high reproducibility of MAT-CHDSP application (κ values 0.93 and 0.95 for intra- and interobserver agreement, respectively). Mean time for data collection and MAT-CHDSP application was 11 min. Adherence to criteria concerning prescription was high (>75 %), but achievement of therapy goals for cholesterol and blood pressure was low (<50 %). Documentation of lifestyle advice achieved intermediate (50–75 %) or low adherence, as did therapy amendments in patients in whom therapy goals were unachieved at hospital admission.

Conclusions

The MAT-CHDSP offers a means to identify both adherence and nonadherence to CPGs concerning CHDSP is applicable in retrospective assessment of CHDSP, and identifies potentials for improved patient care.

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Acknowledgement

Thanks to Erik Eidem Skare for data collection.

Conflict of interest/disclosure

The authors have no conflicts of interest.

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Authors and Affiliations

  1. Hospital Pharmacy of North Norway Trust, Tromsoe, Norway

    Beate Hennie Garcia

  2. Department of Pharmacy, University of Tromsoe, Tromsoe, Norway

    Lars Småbrekke

  3. Department of Cardiology, University Hospital of Tromsoe, Tromsoe, Norway

    Thor Trovik

  4. Regional Drug Information Centre of North Norway, University Hospital of Tromsoe, Tromsoe, Norway

    Trude Giverhaug

Authors
  1. Beate Hennie Garcia
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  2. Lars Småbrekke
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  3. Thor Trovik
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  4. Trude Giverhaug
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Correspondence to Beate Hennie Garcia.

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Garcia, B.H., Småbrekke, L., Trovik, T. et al. Application of the MAT-CHDSP to assess guideline adherence and therapy goal achievement in secondary prevention of coronary heart disease after percutaneous coronary intervention. Eur J Clin Pharmacol 69, 703–709 (2013). https://doi.org/10.1007/s00228-012-1402-7

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  • DOI: https://doi.org/10.1007/s00228-012-1402-7

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