{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T09:18:29Z","timestamp":1765012709668,"version":"3.46.0"},"reference-count":58,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,8,2]]},"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to determine the association between physician adherence to prescribing guideline-recommended medications during hospitalisation and 6-month major adverse outcomes of patients with acute coronary syndrome in Vietnam.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The study was carried out in two public hospitals in Vietnam between January and October 2015. Patients were followed for 6\u2009months after discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Patients who survived during hospitalisation with a discharge diagnosis of acute coronary syndrome and who were eligible for receiving at least one of the four guideline-recommended medications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Exposures<\/jats:title>\n                    <jats:p>Guideline adherence was defined as prescribing all guideline-recommended medications at both hospital admission and discharge for eligible patients. Medications were antiplatelet agents, beta-blockers, ACE inhibitors or angiotensin II receptor blockers and statins.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measure<\/jats:title>\n                    <jats:p>Six-month major adverse outcomes were defined as all-cause mortality or hospital readmission due to cardiovascular causes occurring during 6\u2009months after discharge. Cox regression models were used to estimate the association between guideline adherence and 6-month major adverse outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 512 patients were included. Of those, there were 242 patients (47.3%) in the guideline adherence group and 270 patients (52.3%) in the non-adherence group. The rate of 6-month major adverse outcomes was 30.5%. A 29% reduction in major adverse outcomes at 6\u2009months after discharge was found for patients of the guideline adherence group compared with the non-adherence group (adjusted HR, 0.71; 95% CI, 0.51 to 0.98; p=0.039). Covariates significantly associated with the major adverse outcomes were percutaneous coronary intervention, prior heart failure and renal insufficiency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In-hospital guideline adherence was associated with a significant decrease in major adverse outcomes up to 6\u2009months after discharge. It supports the need for improving adherence to guidelines in hospital practice in low-income and middle-income countries like Vietnam.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-017008","type":"journal-article","created":{"date-parts":[[2017,10,5]],"date-time":"2017-10-05T20:30:33Z","timestamp":1507235433000},"page":"e017008","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Association between in-hospital guideline adherence and postdischarge major adverse outcomes of patients with acute coronary syndrome in Vietnam: a prospective cohort study"],"prefix":"10.1136","volume":"7","author":[{"given":"Thang","family":"Nguyen","sequence":"first","affiliation":[{"name":"Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam"},{"name":"Groningen Research Institute of Pharmacy, Unit of PharmacoTherapy, Epidemiology & Economics, University of Groningen, Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khanh K","family":"Le","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hoang T K","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dao T T","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linh M","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trang N D","family":"Thai","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hoa T K","family":"Pham","sequence":"additional","affiliation":[{"name":"Cardiac Ward, Can Tho General Hospital, Can Tho, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phong T","family":"Pham","sequence":"additional","affiliation":[{"name":"Cardiac Ward, Can Tho Central General Hospital, Can Tho, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thao H","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, School of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eelko","family":"Hak","sequence":"additional","affiliation":[{"name":"Groningen Research Institute of Pharmacy, Unit of PharmacoTherapy, Epidemiology & Economics, University of Groningen, Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tam T","family":"Pham","sequence":"additional","affiliation":[{"name":"Faculty of Public Health, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katja","family":"Taxis","sequence":"additional","affiliation":[{"name":"Groningen Research Institute of Pharmacy, Unit of PharmacoTherapy, Epidemiology & Economics, University of Groningen, Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,10,5]]},"reference":[{"key":"2025120601135510000_7.10.e017008.1","unstructured":"World Health Organization. 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