Learning needs of general practitioners in the management of acute myocardial infarction with ST segment elevation and pharmacological reperfusión strategies
DOI:
https://doi.org/10.56294/shp2024147Keywords:
acute myocardial infarction, primary health care, General Practitioners, Health Knowledge, farmacological treatment of myocardial infarctionAbstract
Introduction: Ischemic heart disease is the leading cause of death worldwide. Initial management in primary care centers is associated with early recognition of the condition, as well as the implementation of immediate and effective therapeutic strategies. In this systematic review, the existing empirical evidence was gathered on the learning needs required by recently received general practitioners for the management of acute myocardial infarction with ST segment elevation and its respective pharmacological reperfusion strategy in the primary care of this pathology. Material and methods:A systematic review of more than 30 articles available from the literature was carried out, including the recommendations of national guidelines (Argentine Society of Cardiology), international guidelines (American Heart Association and European Society of Cardiology) as well as the most medical search engines. relevant for the management of AMI and its pharmacological reperfusion. Result: In this systematic review, deficits were revealed to include lack of recognition and adequate treatment of AMI symptoms, delays in care, deficiencies in ECG interpretation, and limitations in training in emergency procedures. Although there is a general understanding about the use of certain drugs (such as aspirin and beta- blockers), some physicians are unaware of treatment protocols, also identifying shortcomings in referral strategies and a limited availability of educational resources. Conclusión; The crucial role that primary care plays in the early identification and management of STEMI symptoms is highlighted. To improve primary care, it is suggested to train staff, implement standardized protocols, and use technology that facilitates diagnosis and treatment. It is essential that health policies prioritize primary care and promote the integration of services to address STEMI more effectively. There is great potential to improve care through collaboration between different sectors.
References
1. Gagliardi JA, Charask A, Perna E, D'Imperio H, Bono J, Castillo Costa Y, et al. Encuesta nacional de infarto agudo de miocardio con elevación del ST en la República Argentina (ARGEN-IAM-ST). Rev Argent Cardiol. 2016;84(6):Ciudad Autónoma de Buenos Aires.
2. Adaro D, Celeste V, Alvarado Giménez JS, Morales IL, Vega GG, Gagliardi J, et al. Revista del Consejo Argentino de Residentes de Cardiología. 2021;(pág. 162):Argentina.
3. Bancos Salud. Actualizaciones de médicos de primer nivel [Internet]. Argentina: bancos.salud.gob.ar; 2020 jun [citado 2024 abr 18]. Disponible en: https://bancos.salud.gob.ar/sites/default/files/
4. Kusmana D. Role of general practitioner in the management of acute myocardial infarction. Med J Indones. 1999;14(4).
5. Bridgwood B, Cezar S, Houghton J, Andrew N, Coral P, Sayers R. Medical education in a post COVID-19 era: remote teaching methods for cardiovascular knowledge and skills. MedEdPublish. 2021 Mar;10(62):[publicado en línea].
6. Piombo C, Rolandi F, Fitz MM, Salzberg SI, Strumminger. [Faltan datos clave para referenciar adecuadamente. Por favor completar]
7. Custodio-Sánchez P, Miranda-Noé D, López-Rojas M. Propuesta de manejo inicial del infarto de miocardio con elevación del segmento ST no complicado en centros sin capacidad de intervención coronaria percutánea en el Perú. Arch Peru Cardiol Cir Cardiovasc. 2023 Oct–Dec;4(4):164–83.
8. Delgado-Acosta H, Pedraza-Alejo D, Valladares-Carvajal F, Lastre-Navarro K, Hernández-Torres L, Ávila-Piña D. Calidad de la atención médica a pacientes con infarto agudo. Cienfuegos 2011. Rev Finlay [Internet]. 2013 [citado 2024 jul 12].
9. Fernández HE, Bilbao JA, Cohen Arazi H, Ayerdi ML, Telayna JM, Duronto EA, et al. Registro Multicéntrico SCAR: Rev Argent Cardiol. 2014;82(5):Ciudad Autónoma de Buenos Aires.
10. Fady Y, Zainah M, Gurbinder Kaur JS, Nor Haty H. Identifying educational needs and knowledge gaps in healthcare professionals for effective management of acute myocardial infarction. 2024 Jun;11(6):37–43.
11. Weston CFM, Penny WJ, Julian DG, on behalf of the British Heart Foundation Working Group. Guidelines for the early management of patients with myocardial infarction. BMJ. 1994 Mar 19;308.
12. Folgarait A. Radiografía del infarto en la Argentina. Sociedad Argentina de Cardiología. 2016 nov 7.
13. Fumagalli J, Monsalvo M, Gaglio R, Gil A, Koren L. Ministerio de Salud. Resolución 256. Buenos Aires, AR: 2013 oct 14.
14. Smolderen KG, Spertus JA, Nallamothu BK. Health care insurance, financial concerns in accessing care, and delays to hospital presentation in acute myocardial infarction. JAMA. 2010;303(14):1392–400.
15. Solla RI, Bembibre Vázquez L, Freire Corzo J. Actualización de “ABCDE en Urgencias Extrahospitalarias”: Manejo del síndrome coronario agudo en urgencias de atención primaria. Cad Aten Primaria. 2011;18:49–55.
16. Costabel JP, Quintana M, Perea J, Lamelas P. Documento de posición sobre la mejoría de la reperfusión del IAMCEST en Latinoamérica. Arch Cardiol Méx. 2024 abr-jun;94(2):Ciudad de México.
17. Pourmand A, Tanski M, Steven D, Hamid S, Raymond L, Fareen Z. Educational technology improves ECG interpretation of acute myocardial infarction among medical students and emergency medicine residents. 2015 jan.
18. Rosende A, García Zamora S, Venentini N. Guía de práctica clínica nacional para la reperfusión del infarto agudo de miocardio. Ministerio de Salud; 2020. Argentina.
19. Stocco Aimoli U, Miranda CH. Competence in ST-segment elevation myocardial infarction management by recently graduated physicians applying for a medical residency program. Arq Bras Cardiol. 2020 ene;114(1).
20. Varela García RJ, Olivera Escalona ÁL, Guarton Ortiz OM, Est Dariannis VI, M. Necesidades de aprendizaje de médicos de atención primaria sobre reperfusión coronaria en el infarto agudo del miocardio. Medisan. 2019 mar-abr;9:3–10.
21. Ayanian JZ, Hauptman PJ, Guadagnoli E, Antman EM, Pashos CL, McNeil BJ. Knowledge and practices of generalist and specialist physicians regarding drug therapy for acute myocardial infarction. N Engl J Med. 1994 Oct 27;331(17).
22. Zylbersztejn H, Rubio E, Ulmete E, Mitelman PDPJ. Registro de calidad de atención del infarto agudo de miocardio en los hospitales públicos de la ciudad de Buenos Aires. Rev Argent Cardiol. 2010 mayo 17;79(2).
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