Ussanee Phed-on RN*, Saowanee Naowapanich RN*, Umaporn Poolsawat RN*, Akarin Nimmannit MD*, Nattawut Wongpraparut MD, FACP, FACC, FSCAI*
Affiliation : * Division of Cardiology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand
Objective : To evaluate the effectiveness of medical and health education checklist according to ACC/AHA guidelines for
improving compliance in the patients with coronary heart disease who underwent percutanoeus coronary intervention (PCI).
Material and Method: This study was a prospective cohort study between control group (historical coronary artery disease
(CAD) cases who underwent PCI between October 2008 and May 2009) and a case group (CAD cases who underwent PCI
between May 2009 and January 2010) at Her Majesty Cardiac Center floor 8th and Cardiac Care Unit, Faculty of Medicine,
Siriraj Hospital, Mahidol University. In the control group, basic care proceed. In the case group, usual cares plus medical
and health educational checklists proceed at 24 hours Post PCI, before discharge and at 6 months follow-up at PCI clinic.
Results : The study consisted of 160 patients, 79 patients in the control group and 81 patients in the case group. In the case
group, patient received more frequent use of in-hospital ACE-I (100% vs. 72%, p < 0.001), β blockers (100% vs. 61.5%, p
< 0.001). At 6 month follow-up, the use of ACE-I (100% vs. 84.6%, p < 0.001) and β blockers (100% vs. 82.1%, p < 0.001),
remain higher in the case group. Comparing case group and control group,using the applied post PCI medical checklist
correlated with more frequent use of in hospital angiotensin-converting enzyme inhibitors (100% vs. 71.8%, p < 0.001), β
blockers (100% vs. 61.5%, p < 0.001). When looking at the quality of care indicators between two groups at 6 month follow-
up, the patients with DM, CKD in the case group have better blood pressure control according to the guidelines (64.5% vs.
35.1%, p < 0.001). Six-month readmission rates were higher in control group as compared to case group (12.7% versus
5.2%, p < 0.005).
Conclusion : We found that applied medical and health educational checklists improve both adhering to the best practice
guideline and clinical outcome in the patients with CAD underwent PCI.
Keywords : Checklist, Adhering to guideline, Quality of care, Coronary artery disease
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