Background/Objective: Effective disease management among the growing pool of coronary event survivors is essential, but sub-optimally implemented. Contemporary models of care which are safe, benefit the majority and are cost-effective afford innovation in service delivery. However, knowledge translation is becoming increasingly difficult as the volume of trial evidence of disparate models of delivery escalates. We aimed to synthesise existing evidence into an integrated model that could be offered across diverse populations and settings.
Methods: We identified published systematic reviews of secondary prevention interventions for coronary disease using electronic databases. Using an iterative approach, we analysed interventions and synthesised program information.
Results: A united organisation of care to facilitate coordinated secondary prevention for all in need (SPAN) was derived. Core elements identified were (i) index assessment, (ii) disease management education, (ii) personalised risk reduction program with ongoing support and (iv) reassessment. Programs were integrated according to content, contact, format, duration and setting. SPAN can be delivered across any area health service commensurate with available resources regardless of a patient’s age, gender, ethnicity or geographical location. Importantly, the setting, communication technologies and components of each patient’s care are governed and woven into standard medical care in concert with a cardiac care facilitator.
Conclusions: SPAN is a patient care map based on synthesis of scientific evidence. SPAN is inherently flexible but also provides a minimum level of standardisation. SPAN provides an organisation of care by which health services and providers can narrow the current evidence-practice gap and meet future demands.