caa a22 4500 555306054 CHVBK 20200410094045.0 cr unu---uuuuu 190206s2014 xx s 000 0 eng 1932-6203 10.1371/journal.pone.0093147 doi 10.1371/journal.pone.0093147 doi (BORIS)oai:boris.unibe.ch:50113 (ZORA)oai:www.zora.uzh.ch:107703 (SERVAL)BIB_196A04D0B560 360 ddc 610 ddc 24676282 pmid 000333677500082 isiid Quality of care after acute coronary syndromes in a prospective cohort with reasons for non-prescription of recommended medications [Elektronische Daten] [Reto Auer, Baris Gencer, Lorenz Räber, Roland Klingenberg, Sebastian Carballo, David Carballo, David Nanchen, Jacques Cornuz, John-Paul Vader, Pierre Vogt, Peter Jüni, Christian M Matter, Stephan Windecker, Thomas Felix Lüscher, François Mach, Nicolas Rodondi] publishedVersion openAccess eu-repo BACKGROUND Adherence to guidelines is associated with improved outcomes of patients with acute coronary syndrome (ACS). Clinical registries developed to assess quality of care at discharge often do not collect the reasons for non-prescription for proven efficacious preventive medication in Continental Europe. In a prospective cohort of patients hospitalized for an ACS, we aimed at measuring the rate of recommended treatment at discharge, using pre-specified quality indicators recommended in cardiologic guidelines and including systematic collection of reasons for non-prescription for preventive medications. METHODS In a prospective cohort with 1260 patients hospitalized for ACS, we measured the rate of recommended treatment at discharge in 4 academic centers in Switzerland. Performance measures for medication at discharge were pre-specified according to guidelines, systematically collected for all patients and included in a centralized database. RESULTS Six hundred and eighty eight patients(54.6%) were discharged with a main diagnosis of STEMI, 491(39%) of NSTEMI and 81(6.4%) of unstable angina. Mean age was 64 years and 21.3% were women. 94.6% were prescribed angiotensin converting enzyme inhibitors/angiotensin II receptor blockers at discharge when only considering raw prescription rates, but increased to 99.5% when including reasons non-prescription. For statins, rates increased from 98% to 98.6% when including reasons for non-prescription and for beta-blockers, from 82% to 93%. For aspirin, rates further increased from 99.4% to 100% and from to 99.8% to 100% for P2Y12 inhibitors. CONCLUSIONS We found a very high adherence to ACS guidelines for drug prescriptions at discharge when including reasons for non-prescription to drug therapy. For beta-blockers, prescription rates were suboptimal, even after taking into account reason for non-prescription. In an era of improving quality of care to achieve 100% prescription rates at discharge unless contra-indicated, pre-specification of reasons for non-prescription for cardiovascular preventive medication permits to identify remaining gaps in quality of care at discharge. Clinic for Cardiology zora Auer Reto joint author Gencer Baris joint author Räber Lorenz joint author Klingenberg Roland joint author Carballo Sebastian joint author Carballo David joint author Nanchen David joint author Cornuz Jacques joint author Vader John-Paul joint author Vogt Pierre joint author Jüni Peter joint author Matter Christian M. joint author Windecker Stephan joint author Lüscher Thomas Felix joint author Mach François joint author Rodondi Nicolas joint author PLoS ONE 9(3), e93147 1932-6203 https://boris.unibe.ch/50113/1/Auer%20PLoSOne%202014.pdf text/html WWW-Backlink auf das Repository 1 info:eu-repo/semantics/article boris PeerReviewed boris peerstatus BORIS 856 40 https://boris.unibe.ch/50113/1/Auer%20PLoSOne%202014.pdf text/html WWW-Backlink auf das Repository BORIS 700 1- Auer Reto joint author BORIS 700 1- Gencer Baris joint author BORIS 700 1- Räber Lorenz joint author BORIS 700 1- Klingenberg Roland joint author BORIS 700 1- Carballo Sebastian joint author BORIS 700 1- Carballo David joint author BORIS 700 1- Nanchen David joint author BORIS 700 1- Cornuz Jacques joint author BORIS 700 1- Vader John-Paul joint author BORIS 700 1- Vogt Pierre joint author BORIS 700 1- Jüni Peter joint author BORIS 700 1- Matter Christian M. joint author BORIS 700 1- Windecker Stephan joint author BORIS 700 1- Lüscher Thomas Felix joint author BORIS 700 1- Mach François joint author BORIS 700 1- Rodondi Nicolas joint author BORIS 773 0- PLoS ONE 9(3), e93147 1932-6203 ZORA 856 40 https://www.zora.uzh.ch/id/eprint/107703/1/journal.pone.0093147.pdf text/html WWW-Backlink auf das Repository ZORA 700 1- Auer Reto joint author ZORA 700 1- Gencer Baris joint author ZORA 700 1- Räber Lorenz joint author ZORA 700 1- Klingenberg Roland joint author ZORA 700 1- Carballo Sebastian joint author ZORA 700 1- Carballo David joint author ZORA 700 1- Nanchen David joint author ZORA 700 1- Cornuz Jacques joint author ZORA 700 1- Vader John-Paul joint author ZORA 700 1- Vogt Pierre joint author ZORA 700 1- Jüni Peter joint author ZORA 700 1- Matter Christian M. joint author ZORA 700 1- Windecker Stephan joint author ZORA 700 1- Lüscher Thomas Felix joint author ZORA 700 1- Mach François joint author ZORA 700 1- Rodondi Nicolas joint author ZORA 773 0- PLoS ONE 9(3):e93147 SERVAL 700 1- Auer R. aut SERVAL 700 1- Gencer B. aut SERVAL 700 1- Räber L. aut SERVAL 700 1- Klingenberg R. aut SERVAL 700 1- Carballo S. aut SERVAL 700 1- Carballo D. aut SERVAL 700 1- Nanchen D. aut SERVAL 700 1- Cornuz J. aut SERVAL 700 1- Vader J.P. aut SERVAL 700 1- Vogt P. aut SERVAL 700 1- Jüni P. aut SERVAL 700 1- Matter C.M. aut SERVAL 700 1- Windecker S. aut SERVAL 700 1- Lüscher T.F. aut SERVAL 700 1- Mach F. aut SERVAL 700 1- Rodondi N. aut SERVAL 773 0- Plos One 9/3(2014), e93147 9:3<e93147 2014 9 BK010053 XK010053 XK010000 BORIS BORIS BORIS info:eu-repo/semantics/article openAccess ZORA ZORA ZORA Journal Article openAccess SERVAL SERVAL SERVAL article