[Cracovian program for secondary prevention of ischemic heart disease. Methods of intervention].

The Cracovian Program for Secondary Prevention of Ischaemic Heart Disease carried out in cooperation with the Cracow Branch of Polish Cardiac Society is the first and so far the only attempt in Poland to extensively assess the quality of care in terms of secondary prevention of ischaemic heart disease, at the same time trying to influence both the physicians and patients. The results of the 1st stage of the Cracovian Program conducted in 1997-98 indicate that the recommendations for secondary prevention of ischaemic heart disease are not implemented to a satisfactory degree during hospitalization in cardiology departments of university and general hospitals in Cracow, as well as in the post-discharge period. Because of this, measures were undertaken to improve the quality of secondary prevention. Current recommendations for secondary prevention of ischaemic heart disease were presented and discussed during trainings for physicians from the participating centres and primary care physicians. At the same time the results of the 1st stage of the Cracovian Program were presented and the discrepancies between recommendations and everyday practice were identified. Two types of leaflets concerning secondary prevention were also given to patients discharged from the participating departments. In the 2nd stage of the Cracovian Program for Secondary Prevention of Ischaemic Heart Disease carried out in 1999-2000, the implementation of recommendations on secondary prevention was reassessed. The analysis of data obtained in the 2nd stage shows to what extent progress in research dealing with patients with ischaemic heart disease is reflected in everyday practice. It also allows for the evaluation of the impact of the above described intervention on the frequency of achieving the goals defined in the guidelines of cardiac societies. In this paper the genesis, outline and objectives of the project are discussed as well as the methods of intervention applied. The implementation of secondary prevention guidelines both during hospitalization and after discharge will be discussed in separate publications.