Type of publication:
Conference abstract
Author(s):
*Bhambra G.; Fan L.
Citation:
Heart. Conference: BACPR Annual Conference 2025. Glasgow United Kingdom. 111(Supplement 5) (pp A9), 2025. Date of Publication: 01 Nov 2025.
Abstract:
Background Acute Coronary Syndrome (ACS) management relies on timely and accurate prescribing of evidence-based pharmacological therapies as per NICE NG185 guidelines. However, inconsistencies in prescribing practices, especially between cardiology-trained and non-cardiology clinicians, can lead to delays in optimal treatment, inconsistencies in care, and suboptimal discharge planning. Aim To evaluate whether implementing a standardised electronic prescribing order set improves compliance with NICE NG185 recommendations in ACS patients admitted to a tertiary cardiology centre. Method A retrospective review was conducted using EPMA (Electronic Prescribing and Medicines Administration) preintervention (June-October 2022, n=221) and post intervention (February-March 2023, n=76). Patients admitted with STEMI or NSTEMI were assessed within 1-3 days of admission for prescribing compliance with five core ACS medications: aspirin, beta-blockers, statins, proton pump inhibitors (Table present) (PPIs) and ACE inhibitors (ACEi). Following governance approval, a standardised electronic NICE-aligned order set was implemented on the EPMA system. Prescribing compliance pre and post intervention were compared and analysed for significance. Results Pre-intervention (NSTEMI=104, STEMI=117) revealed universal aspirin prescribing (100%), but notable omissions in other therapies: beta-blockers (70.6%), PPIs (72.9%), ACEi (71.5%) and statins (91.4%) [table 1]. Post-intervention (NSTEMI=28, STEMI=48) showed significant prescribing improvements: beta-blockers: +20.2% (p=0.0007), PPIs: +15.3% (p=0.0102), and ACEi: +10.1% (p=0.1143). Statin prescribing showed smaller changes (+3.3%) [table 1]. Conclusion Introducing standardised electronic order sets significantly improved prescribing compliance for ACS medications, particularly beta-blockers and PPIs. This intervention promoted adherence to NICE NG185 guidelines, reduced prescribing variability, streamlined medication reconciliation and improved discharge readiness. Embedding digital decision-support tools into EPMA can enhance early initiation of secondary prevention and facilitate a smoother transition to cardiovascular rehabilitation to optimise ACS care. Future directions will focus on sustainability and scalability across additional clinical settings and specialties to standardise ACS care.
DOI: 10.1136/heartjnl-2025-BACPR.15
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