How effective are service organisation interventions for management of secondary prevention of ischaemic heart disease (IHD) in primary care?
Caution must be exercised in interpreting these results because of the significant heterogeneity between studies. Few trials measured the same outcomes. Limited data were available on the effect on diet. There were insufficient studies or data to suggest the effectiveness of interventions is affected by the type of lead primary care professional. There was some evidence of a “ceiling effect”, whereby interventions have a diminishing beneficial effect once certain levels of risk factor management are reached.
IHD is a major cause of mortality and morbidity. Secondary prevention aims to prevent subsequent acute events in people with established IHD. While the benefits of individual medical and lifestyle interventions are established, the effectiveness of interventions which seek to improve the way secondary preventive care is delivered in primary care or community settings is less certain.