الفهرس 
Quality of health careOnly 14 pages are availabe for public view
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Abstract
AMI continues to be a significant public health problem in industrialized countries and is becoming an increasingly significant problem in developing countries. CHD exerts a significant burden on the economy. The MI has social and psychological implications, both as an indicator of a major health problem and as a measure of disease prevalence in population statistics and outcomes of clinical trials.
Although, the combination of evidence-based medical therapy was independently and strongly associated with lower mortality in patients with ACS, there are substantial gaps between the care that patients receive and the practice the evidence suggests is effective. EBM is improving the quality and consistency of clinical care. Evidence-based CPG are seen as a cornerstone and as important tools for the implementation and dissemination of the concept of EBM. The goal of a guideline is to arrive at an agreement as to how patients should be treated, potentially providing them with greater consistency of care.
This study aims:
1. To identify evidence-based cardiac medications for treatment of patients with acute myocardial infarction.
2. To determine the degree of compliance of current practice with the developed evidence-based cardiac medications for the treatment of patients with acute myocardial infarction.
3. To assess awareness of physicians regarding evidence-based medicine.
It was conducted in Gamal Abdel-Nasser hospital in Alexandria, the major Health Insurance hospital in Alexandria (1001 beds in 2006). It is a descriptive study that included retrospective and cross sectional design.
The study sample consists of all medical records of cases discharged from the hospital during the year 2006 with the diagnosis of AMI who met the study criteria (Out of 462 cases of AMI discharged during the year 2006, 414 met the study criteria, of which 321 records were legible for the study). All physicians in the general medical departments and in the CCU (a total of 46 physicians, of which 35 replied), who are granted the authority to manage cardiac cases, are included in this study.
As regards data collection; for the retrospective study, data collection was carried out using a specially designed form to review data from the records. Internet websites were accessed to identify evidence-based guidelines for the management of patients with AMI. Then patients’ medical records were reviewed and the following data were collected using a specially designed form: demographic data including age and sex, clinical department, hospital length of stay, days spent in CCU, location of infarction, in-hospital treatment (including, use of ß-blockers, aspirin, ACEI or ARB, lipid-lowering agents, and fibrinolysis, percutaneous coronary interventions or coronary artery bypass grafting), discharge medications, co-morbidities (including smoking, diabetes, hyperlipidemia, hypertension, and obesity) and in-hospital mortality.
In the cross sectional study, a self administered questionnaire was administered to all physicians of general medical departments and CCU of Gamal Abdel-Nasser hospital, to identify physicians’
1. Demographic and professional characteristic (e.g. age, primary work area, job class, years of service after specialization, years of service in the hospital and any previous training on EBM).
2. Awareness and attitude towards EBM.
3. Ability to access relevant databases and the world wide web.
4. Understanding of technical terms used in EBM.
5. Views on the perceived major barriers to practicing EBM.
6. Views on how to move from opinion based to EBM.