Benefit of post PCI medical checklist to improve adhering with best practice guidelines in the patients with coronary artery disease undergoing percutaneous coronary intervention (PCI)

To evaluate the effectiveness of medical and health education checklist according to ACC/AHA guidelines for improving compliance in the patients with coronary heart disease who underwent percutanoeus coronary intervention (PCI). This study was a prospective cohort study between control group (historical coronary artery disease (CAD) cases who underwent PCI between October 2008 and May 2009) and a case group (CAD cases who underwent PCI between May 2009 and January 2010) at Her Majesty Cardiac Center floor 8th and Cardiac Care Unit, Faculty of Medicine, Siriraj Hospital, Mahidol University. In the control group, basic care proceed. In the case group, usual cares plus medical and health educational checklists proceed at 24 hours Post PCI, before discharge and at 6 months follow-up at PCI clinic. The study consisted of 160 patients, 79 patients in the control group and 81 patients in the case group. In the case group, patient received more frequent use of in-hospital ACE-I (100% vs. 72%, p < 0.001), beta blockers (100% vs. 61.5%, p < 0.001). At 6 month follow-up, the use of ACE-I (100% vs. 84.6%, p < 0.001) and beta blockers (100% vs. 82.1%, p < 0.001), remain higher in the case group. Comparing case group and control group,using the applied post PCI medical checklist correlated with more frequent use of in hospital angiotensin-converting enzyme inhibitors (100% vs. 71.8%, p < 0.001), beta blockers (100% vs. 61.5%, p < 0.001). When looking at the quality of care indicators between two groups at 6 month followup, the patients with DM, CKD in the case group have better blood pressure control according to the guidelines (64.5% vs. 35.1%, p < 0.001). Six-month readmission rates were higher in control group as compared to case group (12.7% versus 5.2%, p < 0.005). We found that applied medical and health educational checklists improve both adhering to the best practice guideline and clinical outcome in the patients with CAD underwent PCI.