Summary of findings and quality assessment
| Outcome | Quality assessment (serious limitation, yes/no/unknown) | Summary of findings | Quality of the evidence (GRADE) | |||||||
| Study design | Indirectness | Substantial statistical heterogeneity | Imprecision | Publication bias | Illustrative comparative risks (95% CI) | Relative effect, OR (95% CI) | No. of patients (studies) | |||
| Assumed risk in comparison | Corresponding risk in intervention | |||||||||
| ASA/APA | Yes* | No | No | No | No | 851 per 1000 | 866 per 1000 (832 to 894) | 1.13 (0.87 to 1.47) | 5589 (10 studies) | Moderate |
| BB | Yes* | No | No | No | No | 840 per 1000 | 856 per 1000 (830 to 878) | 1.13 (0.93 to 1.37) | 4489 (10 studies) | Moderate |
| ACEI/ARB | No | No | No | No | Unknown† | 735 per 1000 | 743 per 1000 (709 to 773) | 1.04 (0.88 to 1.23) | 2853 (9 studies) | High |
| Statin/LLA | Yes* | No | No | No | No | 770 per 1000‡ | 805 per 1000 (782 to 826) | 1.23 (1.07 to 1.42) | 5238 (12 studies) | Moderate |
| Composite | No | No | No | No | Unknown† | 566 per 1000 | 583 per 1000 (488 to 673) | 1.07 (0.73 to 1.58) | 460 (2 studies) | High |
| Target BP | Yes* | No | No | No | Unknown† | 432 per 1000 | 526 per 1000 (458 to 595) | 1.46 (1.11 to 1.93) | 1580 (4 studies) | Moderate |
| Target LDL-C/cholesterol | Yes* | No | No | No | Unknown† | 704 per 1000 | 714 per 1000 (682 to 744) | 1.05 (0.90 to 1.22) | 3194 (6 studies) | Moderate |
| Mortality | No | No | No | Yes§ | Unknown† | 84 per 1000 | 67 per 1000 (42 to 104) | 0.78 (0.48 to 1.27) | 1341 (2 studies) | Moderate |
Patient or population: patients with ischaemic heart diseases.
Comparison: usual care or less intensive intervention.
Intervention: interventions intended to improve prescribing guideline-recommended medications and patients’ health outcomes.
§Included study had few events and wide CI.
*More than one-third of studies had recruitment bias.
†Did not perform Egger’s test because of number of studies <10.
‡Not included the study by Hung et al because its population was the patients not receiving statin/LLA appropriately at baseline.
Setting: hospitals, general practices/primary care practices, cardiology clinics or pharmacies.
ACEI, ACE inhibitors; APA, antiplatelet agents; ARB, angiotensin II receptor blockers; ASA, aspirin; BB, beta-blockers; BP, blood pressure; GRADE, grading of recommendations assessment, development and evaluation; LDL-C, low-density lipoprotein cholesterol; LLA, lipid-lowering agents.