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An audit of secondary prevention of coronary heart disease in post acute myocardial infarction patients in primary care

Introduction: The National Service Framework for Coronary Heart Disease (CHD) defines national standards for delivering care after acute myocardial infarction (AMI). Objectives: To improve appropriate use of secondary prevention measures and investigations after an AMI at the interface of primary and secondary care. Method:Criteria for this audit were selected from those devised by the National Institute for Clinical Excellence: Audit of the Management of Post-MI Patients in Primary Care. A retrospective review was conducted of general practitioner (GP) records,for patients who were identified as being treated in hospital for AMI. Baseline audit data were collected in 2003 for patients treated for an AMI in 2001.Following a multifaceted intervention a re-audit was conducted in 2004 of patients treated for an AMI in 2002. Results :Data were collected for 340 patients from 78 practices for the baseline audit, and for 203 patients from 51 practices for the re-audit. Comparison of primary care trusts (PCTs) showed a variation in meeting the audit criteria at baseline and re-audit, but overall 9 out of 10 audit criteria were better achieved in the re-audit than at baseline. Conclusion :Baseline audit suggested standards of secondary prevention of CHD in post-MI patients were good overall, but there were variations in care between PCTs. Re-audit results suggest standards of care have improved overall after a multifaceted intervention.


Alison Dunkley,

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