Re: Many people receive suboptimal care after myocardial infarction, research shows
I read the article by Jacqui Wise titled "Many people receive suboptimal care after myocardial infarction, research shows” in last week’s BMJ issue, with great interest. It has highlighted a very important topic and demonstrated the major impact suboptimal care has had on patient healthcare. Only a small percentage of patients were receiving interventions for which they were eligible.
Most patients did not receive dietary or smoking cessation advice after suffering an NSTEMI, despite these being simple yet effective interventions. Any member of the healthcare team could help make these interventions, as the patient will be in contact with the team during their hospital stay as well as after discharge. Making the healthcare team aware of these shortcomings and the development of a consistent approach to delivering such lifestyle advice could help with improvement.
It was interesting to also see that some patients were not receiving pharmacological therapy for secondary prevention of a myocardial infarction, such as aspirin and statins, as recommended by the National Institute for Health and Care Excellence. I had recently undertaken a re-audit of secondary prevention of myocardial infarctions in post-MI patients after they had had coronary artery bypass graft surgery, in a hospital I had a placement at. Some of the recommendations from this audit were that there could be electronic prompts on discharge forms to remind the healthcare team to prescribe these drugs. This may be of potential use on a wider scale as well.
In conclusion, as suggested by the article, it is good that these problems have been identified so solutions can be devised. It would also be valuable to investigate further about what other reasons there may be for these shortcomings. This will enable appropriate methods of dealing with these issues, to be identified, and hopefully result in the improvement of the care patients receive.
Competing interests: No competing interests