ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2008
Factors associated with the use of evidence-based therapies after discharge among elderly patients with myocardial infarction.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2010Guideline
- Secondary prevention medication after myocardial infarction: persistence in elderly people over the course of 1 year.Drugs & aging · 2014Trial
- Closing the gap in postfracture care at the population level: a randomized controlled trial.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2012Trial
- Osteoporosis in 2022: Care gaps to screening and personalised medicine.Best practice & research. Clinical rheumatology · 2022Review
- Fragility fracture identifies patients at imminent risk for subsequent fracture: real-world retrospective database study in Ontario, Canada.BMC musculoskeletal disorders · 2021Observational
- FRAX and ethnicity.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Article
- Impact of Age, Multimorbidity and Frailty on the Prescription of Preventive Antiplatelet Therapy in Older Population.International journal of environmental research and public health · 2020Article
- General and Specific Considerations as to why Osteoporosis-Related Care Is Often Suboptimal.Current osteoporosis reports · 2020Review
- Does the association between adherence to statin medications and mortality depend on measurement approach? A retrospective cohort study.BMC medical research methodology · 2017Article
- Review
- Delayed educational reminders for long-term medication adherence in ST-elevation myocardial infarction (DERLA-STEMI): protocol for a pragmatic, cluster-randomized controlled trial.Implementation science : IS · 2012Article
- Physician and patient influences on provider performance: β-blockers in postmyocardial infarction management in the MI-Plus study.Circulation. Cardiovascular quality and outcomes · 2011Article
- Myocardial infarction and quality of care.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2008Review
Corrections and comments
- Commented on by
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn an accompanying article, we report moderate between-hospital variation in the postdischarge use of beta-blockers, angiotensin-modifying drugs and statins by elderly patients who had been admitted to hospital with acute myocardial infarction. Our objective was to identify the characteristics of patients, physicians, hospitals and communities associated with differences in the use of these medications after discharge.
methodsFor this retrospective, population-based cohort study, we used linked administrative databases. We examined data for all patients aged 65 years or older who were discharged from hospital in 2005/06 with a diagnosis of myocardial infarction. We determined the effect of patient, physician, hospital and community characteristics on the rate of postdischarge medication use.
resultsIncreasing patient age was associated with lower postdischarge use of medications. The odds ratios (ORs) for a 1-year increase in age were 0.98 (95% confidence interval [CI] 0.97-0.99) for beta-blockers, 0.97 (95% CI 0.97-0.98) for angiotensin-converting-enzyme inhibitors and angiotensin-receptor blockers and 0.94 (95% CI 0.93-0.95) for statins. Having a general or family practitioner, a general internist or a physician of another specialty as the attending physician, relative to having a cardiologist, was associated with lower postdischarge use of beta-blockers, angiotensin-modifying agents and statins (ORs ranging from 0.46 to 0.82). Having an attending physician with 29 or more years experience, relative to having a physician who had graduated within the past 15 years, was associated with lower use of beta-blockers (OR 0.71, 95% CI 0.60-0.84) and statins (OR 0.81, 95% CI 0.67-0.97).
interpretationPatients who received care from noncardiologists and physicians with at least 29 years of experience had substantially lower use of evidence-based drug therapies after discharge. Dissemination strategies should be devised to improve the prescribing of evidence-based medications by these physicians.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.