Factors associated with the use of evidence-based therapies after discharge among elderly patients with myocardial infarction

Austin et al. found that cardiologists and recent graduates were more likely to prescribe evidence-based drug therapies to patients discharged after suffering an MI. It is not surprising that cardiologists are more up to date concerning evidence-based approaches in their field: cardiologists have only one subject to study. An internist has to stay current several disciplines; a family practitioner has to review many topics.

To help non cardiologists, guidelines concerning the care of patients surviving an MI should be up to date and clearly labeled. Many generalists pay careful attention to letters from the specialist or the hospitalist. It could be helpful if the discharge summary or the consultant's letter were directive: "We started Mr. MI on 81 mg of ASA, 20 mg of rosuvastatin, 10 mg of ramipril, and 80 mg of nadolol a day. He should remain on these medications indefinitely."

It is refreshing for generalists to meet with specialists. If specialists or quality review panels identify that practice in an area differs from that suggested by the best evidence, that topic could be covered at a continuing medical education presentation.

Thank you.

Yours sincerely,

Robert Shepherd

Conflict of Interest:

None declared