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Quality improvement
Recall to a general practitioner or to a nurse clinic improved assessment in patients with coronary artery disease

https://doi.org/10.1136/ebm.7.1.30

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    (2001) BMJ 322, 1338. Moher M, Yudkin P, Wright L. , et al, for the Assessment of Implementation Strategies (ASSIST) Trial Collaborative Group. . Cluster randomised controlled trial to compare three methods of promoting secondary prevention of coronary heart disease in primary care.. Jun 2;. :. –42.
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 QUESTION: In patients with coronary artery disease (CAD), what is the effectiveness of audit and feedback recall to a general practitioner (GP), and recall to a nurse clinic for improving secondary preventive care?

    Design

    Cluster randomised {allocation concealed*}†, unblinded,* controlled trial with 18 months of follow up.

    Setting

    21 general practices in Warwickshire, UK.

    Patients

    2142 patients with established CAD (a previous diagnosis of myocardial infarction and angina, and receiving antianginal drugs or revascularisation by percutaneous transluminal coronary angioplasty or coronary artery bypass). 1906 patients (mean age 66 y, 68% men) completed the study.

    Intervention

    7 practices were allocated to 1 of 3 quality improvement approaches: audit and feedback (audit group, 559 patients), recall to the GP (GP recall group, 682 patients), and recall to the nurse clinic (nurse recall group, 665 patients). Summary audit results of preventive care were given …

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    Footnotes

    • Source of funding: NHS Executive.

    • For correspondence: Dr M Moher, Department of Primary Health Care, University of Oxford, Institute of Health Sciences, Oxford OX3 7LF, UK. Fax +44 (0) 1865 226 720.

    • ↵* See glossary.

    • ↵† Information provided by author.