Sinha Shashank S, Eagle Kim A, Vaishnava Prashant
Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Coron Artery Dis. 2015 Jan;26(1):78-87. doi: 10.1097/MCA.0000000000000180.
Despite the substantial progress in elucidating the pathophysiology of acute coronary syndromes (ACS) and developing an array of therapeutic advances for the management of these conditions, several challenges still persist. The use of guideline recommendations for the care of patients with ACS by both healthcare providers and hospitals can improve short-term and long-term outcomes and potentially reduce healthcare costs. However, evidence suggests that adherence to guidelines is suboptimal. Several quality improvement programs, by both governmental and nongovernmental organizations, have been developed in an attempt to encourage maximal utilization of evidence-based interventions. In this review, we will examine the evidence for the importance of guideline adherence in the management of ACS, explore predictors of adherence to these guidelines, and provide evidence-based strategies for improving their implementation.
尽管在阐明急性冠状动脉综合征（ACS）的病理生理学以及开发一系列用于治疗这些病症的治疗进展方面取得了重大进展，但仍存在一些挑战。医疗保健提供者和医院使用ACS患者护理指南建议可改善短期和长期预后，并有可能降低医疗成本。然而，证据表明，对指南的遵守情况并不理想。政府和非政府组织已经制定了几个质量改进计划，试图鼓励最大限度地利用循证干预措施。在本综述中，我们将研究指南遵守在ACS管理中的重要性的证据，探索这些指南遵守情况的预测因素，并提供基于证据的策略以改善其实施。
