Table 1.
Characteristics of included studies
| No. | Source | Study design |
Study period | Patient follow-up, months | Country | Setting of recruitment | Diagnosis | Intervention group | Control group | Primary outcome | Secondary outcome | Overall risk of bias | ||||||
| Type | No. of patients (clusters) | Age, mean (SD) | Gender, % male |
Type | No. of patients (clusters) | Age, mean (SD) | Gender, % male |
|||||||||||
| 1 | Berwanger et al43 |
Cluster RCT | 2011–2012 | 1 | Brazil | Hospital | ACS | OI plus PI | 602 (17) | 62 (13) | 68.6 | UC | 548 (17) | 62 (13) | 68.6 | ASA, BB, ACEI, statin, composite | 30-day mortality | Low |
| 2 | Bond et al 45 |
RCT | 2002–2004 | 12 | UK | GP/PCP | IHD | OI | 941 | 68.7 (9.2) | 67.4 | UC | 500 | 68.8 (9.1) | 70.6 | ASA, BB, ACEI, LLA |
No | Low |
| 3 | Flather et al47 |
Cluster RCT | 2008 | NA | France, Italy, Poland, Spain, UK | Hospital | NSTEACS | OI plus PI | 722 (19) | 65.6 (10.5) | 67.2 | LII | 479 (18) | 66.1 (10.6) | 72.2 | CLO, BB, ACEI, statin |
No | Low |
| 4 | Garcia et al 49 |
RCT | 2009–2010 | 12 | Norway | Hospital | IHD | OI | 48 | 63.9 (9) | 72 | UC | 46 | 63.4 (9.9) | 72 | ASA, BB, ACEI/ARB, statin |
Target BP, target LDL-C | Low |
| 5 | Guadagnoli et al 50 |
Cluster RCT | 1999–2001 | 6 | USA | Hospital | MI | OI | 232 (184) | 68.3 (11.3) | 66.4 | UC | 227 (210) | 67.3 (12.1) | 63.9 | ASA, BB and ACEI | No | Low |
| 6 | Hung et al 51 |
RCT | 2004–2007 | 6 | Taiwan | Hospital | IHD | PI | 92 | 67 (10) | 71.7 | UC | 102 | 66 (12) | 75.2 | LLA | No | Low |
| 7 | Khunti et al 52 |
Cluster RCT | 2001–2003 | 12 | UK | GP/PCP | IHD | OI | 461 (10) | Median (IQR) 70 (63, 76) |
69 | UC | 619 (10) | Median (IQR) 71 (63, 78) |
60 | ASA, BB, ACEI, LLA |
Target BP, target cholesterol | Low |
| 8 | Levine et al 53 |
Cluster RCT | 2002–2008 | 27 | USA | GP/PCP | post-MI | PI | 3080 (84) | <65: 48.5%; ≥65: 51.5% |
98.8 | LII | 2911 (84) | <65: 46.9%; ≥65: 53.1% |
98.7 | BB, ACEI/ARB, statin | Target LDL-C | Low |
| 9 | McAlister et al 55 |
Cluster RCT | 2005–2008 | 6 | Canada | GP/PCP | IHD | PI | 165 (NR) | 64.5 (10.2) | 72.1 | UC | 157 (NR) | 64.4 (9.6) | 82.1 | APA, BB, ACEI/ARB, statin, composite |
Target LDL-C, 6 month mortality |
Low |
| 158 (NR) | 62.9 (9.7) | 81.7 | ||||||||||||||||
| 10 | Moher et al 56 |
Cluster RCT | 1997–1999 | 18 | UK | GP/PCP | IHD | OI plus PI | 682 (7) | 66.4 (5.6) | 67 | LII | 559 (7) | 66.1 (5.4) | 67 | APA, LLA | No | Low |
| 665 (7) | 65.8 (5.8) | 71 | ||||||||||||||||
| 11 | Ornstein et al 57 |
Cluster RCT | 2002–2003 | 24 | USA | GP/PCP | IHD | OI plus PI | 1422 (10) | NR | NR | LII | 1166 (10) | NR | NR | BB, LLA | Target BP, target LDL-C | Low |
| 12 | Sondergaard et al 58 |
Cluster RCT | 2000–2002 | NA | Denmark | GP/PCP | IHD | PI | 157 (14) | NR | NR | UC | 162 (14) | NR | NR | ASA, LLA | No | Low |
| 13 | Yorio et al 59 |
RCT | 2003–2004 | 12 | USA | Hospital | ACS | OI | 72 | 55.9 (11.3) | 66.7 | UC | 68 | 56.2 (10.8) | 57.3 | ASA, BB, ACEI, statin | Target SBP, target LDL-C | Low |
ACEI, ACE inhibitors; ACS, acute coronary syndrome; APA, antiplatelet agents; ARB, angiotensin II receptor blockers; ASA, aspirin; BB, beta-blockers; BP, blood pressure; CLO, clopidogrel; GP, general practice; IHD, ischaemic heart disease; LDL-C, low-density lipoprotein cholesterol; LII, less intensive intervention; LLA, lipid-lowering agents; MI, myocardial infarction; NA, not applicable; NR, not reported; NSTEACS, non-ST-elevation acute coronary syndrome; OI, organisational intervention; PCP, primary care practice; PI, professional intervention; RCT, randomised controlled trials; SBP, systolic blood pressure; UC, usual care.