Improved treatment of coronary heart disease by implementation of a Cardiac Hospitalization Atherosclerosis Management Program (CHAMP)☆
Section snippets
Methods
The setting for this study was a university-associated teaching hospital. Full-time cardiology and medicine faculty as well as private clinical faculty serve as attending physicians supervising internal or family medicine housestaff. Before 1994, no specific treatment algorithms or management pathways were in place. Care was guided by individual physician decision and individual awareness and adherence to national clinical guidelines, such as the American College of Cardiology/American Heart
Results
From January 1992 to December 1995, 558 consecutive men and women were hospitalized for acute myocardial infarction and met the eligibility criteria, 256 in pre-CHAMP period of 1992 to 1993 and 302 in period after the implementation of CHAMP, 1994 to 1995. Demographic and clinical characteristics for the study groups are shown in Table 1. The 2 groups were similar with regard to a variety of baseline characteristics. Although the proportion of patients undergoing reperfusion therapy were
Discussion
This study demonstrates that CHAMP was an effective means to improve treatment utilization of clinical trial evidence-based therapies. It is also the first study to address the feasibility, safety, and impact on adherence of initiating lipid-lowering medications before discharge in patients hospitalized with acute myocardial infarction.
Prior studies have assessed the impact of programs to improve risk factor modification in patients with coronary artery disease. A physician-directed,
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This study was supported by the Ahmanson Foundation, Los Angeles, California. Manuscript received August 9, 2000; revised manuscript received and accepted October 18, 2000.