Evidence map›Paper›PMID 36599635›Full record

ArticleBMJ open2023

Heartwatch: an Irish cardiovascular secondary prevention programme in primary care, a secondary analysis of patient outcomes.

Robyn Homeniuk, Fintan Stanley, Joseph Gallagher, Claire Collins

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Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Robyn Homeniuk *Research, Policy and Information, Irish College of General Practitioners, Dublin, Ireland.ORCID 0000-0002-5526-4113
Fintan Stanley *Research Hub, Irish College of General Practitioners, Dublin, Ireland.ORCID 0000-0002-6740-3280
Joseph GallagherICGP HSE Primary Care Lead for Integrated Care Programmes (Cardiovascular Disease), Irish College of General Practitioners, Dublin, Ireland.
Claire CollinsResearch, Policy and Information, Irish College of General Practitioners, Dublin, Ireland claire.collins@icgp.ie.ORCID 0000-0001-8967-5159

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo investigate patient follow-up data from Heartwatch: Ireland's secondary prevention programme for cardiovascular disease delivered in general practice.

designRetrospective descriptive study based on secondary analysis of routinely collected data from Heartwatch.

settingHeartwatch targeted 20% of general practices in Ireland and recruited 475 general practitioners across 325 practices.

participantsThe patient population included people with a history of acute myocardial infarction, percutaneous transluminal coronary angioplasty or a coronary artery bypass graft. Over 16 000 patients entered the programme however, to assess the long-term progress of patients, we identified a cohort of 5700 patients with at least 8 years in the programme.

interventionsA standard protocol for continuing care of patients for the secondary prevention of cardiovascular disease was administered by general practices. The programme was designed using WHO and European Society of Cardiology guidelines on secondary prevention. OUTCOME MEASURES: A Continuing Care (CCare) score out of eight was the primary outcome measure used. It was calculated based on programme targets for well-known cardiovascular risk factors: exercise, systolic blood pressure, LDL cholesterol, optimally controlled glucose, smoking status, and pharmacological treatment.

resultsAfter 1 year, 37% of the 8-year cohort had achieved a CCare score >5 increasing to 44% after year 8. Patient sex was predictive of better scores; male patients had almost a half-point advantage (0.432, 99% CI: 0.335 to 0.509). Patients who enrolled earlier following their qualifying event and patients with more frequent visits were also more likely to achieve higher CCare scores.

conclusionsOverall, patients are not likely to meet all targets set by secondary prevention guidelines, however, supporting patient self-management may impact on this. Early enrolment after a cardiac event and frequent structured care visits should be priorities in the design and implementation of similar programmes. Ongoing evaluation of them is necessary to improve outcomes.

Indexed as

Myocardial InfarctionSmokingHumansMalePrimary Health CareRetrospective StudiesSecondary Preventioncardiologycoronary interventionpreventive medicineprimary careprotocols & guidelines

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