Practice Clinical updates

Management of patients after primary percutaneous coronary intervention for myocardial infarction

BMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j3237 (Published 20 July 2017) Cite this as: BMJ 2017;358:j3237

Re: Management of patients after primary percutaneous coronary intervention for myocardial infarction

1 No mention of gastro protection medication, What drug , what dose and ? stop at 1 year when down to single agent

2 No mention about how long for B Blockers. If no reduced ejection fraction ? stop at one year

3 Most importantly manage data in GP system (at least in UK ) Ensure computer prescription records are updated with new medication and importantly add review/stop date to dual therapy as very easy for these to be continued beyond evidence date

In UK practice up-titration of medication often done by cardiac nursing team and potential problems of GP prescription data not matching what the patient thinks they are taking, compounded by the pharmacy supplying possibly having another different record and requesting the wrong dose for the patient

If not totally clear with a written plan for those on triple therapy with an anticoagulant chase the originator on their plans. These are people in a very high risk group and workload pressures may make communication sub optimal

Competing interests: No competing interests

23 July 2017
nicholas j sharvill
GP
Deal Kent