Publication:

Assessment of management approach for myocardial infarction by family physicians in central India: a cross sectional survey

Background Myocardial infarction (MI) is the most common cause of mortality globally. Patients generally consult their family physicians first and hence the role of these physicians in management of is very important. it is thus pertinent to assess the approach to management of MI patients by the primary health care physicians.

Methods A cross-sectional survey was conducted with a validated questionnaire among 232 family physicians in central India.

Results Combination of aspirin, clopidogrel and statins was the treatment of choice by 69.82% of physicians. Use of morphine was not preferred by 87.93% of physicians due to non-availability. Tramadol, diclofenac and pethidine were the analgesics preferred. Use of aspirin was stressed by 91.37% of physicians, of these 56.89% preferred the use of soluble aspirin and 43.10% enteric coated. 91.37% were familiar with ECG findings of MI. As latest treatment of choice 41.37% thought of immediate thrombolysis with tenecteplase whereas 47.41% considered coronary angiogram followed by angioplasty in a nearby cardiac center and 29.74% immediate thrombolysis with streptokinase. Regarding referral to hospital with catheterization laboratory facility, 65.94% opined 3 hours as maximum time period of referral from onset of attack of MI and 43.96% opined it to be 6 hours.

Conclusions Family practitioners play a key role in timely management of acute MI. Hence updating them on the management of acute MI through various continuing medical education programs is considered mandatory so that timely management can help significantly reduce mortality rates in our country.