Télécharger le supplément (250 p.) - KCE

KCE Reports 85 S Médecine à l’acte/médecine au forfait – ANNEXES 9
Patients with CAD and hypertension on treatment and a mean systolic BP >
150/90 should be offered a change in therapy (if not changed in the previous 6
months) (2,3)
Patients with established CAD with a total cholesterol level of > 5 mmol/L
should be offered dietary advice or lipid lowering therapy or a change in
therapy ( ( if not changed in the prior 6 months) (2,3)
Patients with established CAD should have their smoking status recorded since
their disease has been diagnosed (2,3)
Smokers should be given smoking cessation advice at least once since diagnosis
(2,3)
When the record show that the patient is still symptomatic on monotherapy, a
second drug should be offered (9)
regular symptomatic treatment : verapamil or diltiazem when there is a
contrindication to a beta-blocker (20)
Patients with CAD (coronary artery disease) should have their blood pressure
measured and documented at least every 2 years. (2,3)
Patients with CAD should have their BP checked al least yearly if they have a
systolic BP > (>=(3)) 140 mmHg and/or diastolic BP > (>= (3)) 85 mmHg (2,3)
Patients with CAD and sustained systolic BP > 160 mmHg or a diastolic BP > 100
mmHg should be offered anti-hypertensive medication (as necessary to attain
a mean blood pressure of < (
150/90 should be offered a change in therapy (if not changed in the previous 6
months) (2,3)
Sumatriptan non remboursé
Sumatriptan should not be prescribed for migraine in patients with angina (2,3)
critère de sélection des patients étudiés, et médicaments à prescription rare (car usage peu
fréquent, une boite dure longtemps).
For patients with angina, the records should show that the patient has been
offered treatment with sublingual glyceryl trinitrate (9)
For patients with stable angina, initial symptomatic treatment : sublingual glyceryl
trinitrate (20)
Aspirine non remboursée.
Pre-hospital management for patients with AMI and angina: aspirine (100%) –
intramuscular opiates (0%) (8)
Aspirin prescription for eligible patients (1ary prevention and 2ary prevention of
MI – vascular disease ) (8)
Patients with CAD should be advised at least once to take aspirin at the dose of
75-150 mg/day (continued indefinitely) unless they have a contraindication
(2,3,8)
High rate of prescribing of aspirin in patients who are recieving nitrate therapy.
(19)
Patients with angina should be advised at least once to take aspirin at the dose of
75-150 mg/day (continued indefinitely) unless they have a contraindication (8)
For patients with angina, the records should show that the patient has been
offered treatment with aspirin, in the absence of contraindications (9)