Improving cardiovascular disease management in Australia: NPS MedicineWise.

Objectives: To determine the impact of four NPS MedicineWise programs targeting quality use of medicines in cardiovascular management in primary care.
Design: Interrupted time-series analysis using the Department of Veterans' Affairs (DVA) claims dataset from 1 January 2002 to 31 August 2010. We examined the use of antithrombotics in people with atrial fibrillation and in those who had had a stroke, and the use of echocardiography and spironolactone in the population with heart failure.
Participants: All veterans and their dependants in Australia who had received cardiovascular medicines or health services related to the targeted intervention.
Intervention: NPS MedicineWise national programs to improve cardiovascular management in primary care, which included prescriber feedback, academic detailing, case studies and audits as well as printed educational materials.
Main Outcome Measures: Changes in medication and health service use before and after the interventions.
Results: All national programs were positively associated with significant improvements in related prescribing or test request practice. The interventions to improve the use of antithrombotics resulted in a 1.27% (95% CI, 1.26%-1.28%) and 0.63% (95% CI, 0.62%-0.64%) relative increase in the use of aspirin or warfarin in the population with atrial fibrillation 6 and 12 months after the program, respectively, and in a 1.51% (95% CI, 1.49%-1.53%) relative increase in the use of aspirin as monotherapy for secondary stroke prevention 12 months after the intervention. The heart failure programs resulted in a 3.69% (95% CI, 3.67%-3.71%) relative increase in the use of low-dose spironolactone and a 4.31% (95% CI, 4.27%-4.35%) relative increase in the use of echocardiogram tests 12 months after the intervention.
Conclusions: NPS MedicineWise programs were effective in achieving positive changes in medicine and health service use for patients with cardiovascular diseases.