Care of the Post-MI Patient in Primary Care

According to the British Heart Foundation (BHF) in 2006 about 1.3 million people in the UK have had an MI, about 4% of men and 2% of women. Because of their medical history, they will need following up in the primary care setting to help reduce the risk of further events; this is done by a combination of patient education, modification of diet and lifestyle as well as regular checks and medication or further interventions.

In primary care, the major risk factors will therefore be addressed; for example, smoking, obesity, diet, inactive lifestyle, hypertension, dyslipidaemia, poorly-controlled diabetes, as well as ensuring the recommended MI prophylactic medications are prescribed.

Many of these interventions are under QOF with points awarded for specific interventions (such as regular blood pressure checks, blood lipid checks, identification of depression, anxiety or related mental illness, as well as therapies such as ACE inhibitors, beta blockers, aspirin, or angiotensin receptor blockers). It is important for all primary care settings to have robust policies in place for the care of post-MI patients as not all standard therapies are covered by QOF.

Because many of the cardiovascular risk factors are reversible, there needs to be an emphasis on patient education and empowerment. This is the most effective intervention and yet, according to the BHF, less than 40% of post-MI patients have access to this. Primary care nurses are well-placed to provide this.

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