Coronary heart disease (CHD)

Coronary heart disease

Coronary artery disease is the end result of the accumulation of atheromatous plaques within the walls of the coronary arteries that supply the myocardium with oxygen and nutrients. It is sometimes also called coronary heart disease...

, predominantly due to myocardial infarction (MI), is the number one cause of death in the United Kingdom . However, one of its most common initial manifestations, angina, remains as of yet understudied and its burden may be underappreciated. This is partly because diagnosis of stable angina pectoris is based solely on the characterization of the pain as elicited by the doctor. Many patients with typical symptoms of stable angina are not diagnosed as angina and factors such as sex, ethnicity and age may influence the physician’s final recommendations for diagnostic testing such as coronary angiography.

Optimising Management of Angina (OMA) is a cluster randomized controlled trial of a multi-faceted decision support and educational intervention

Health intervention

A health intervention is an effort to promote good health behaviour such as physical exercise or to prevent bad health behaviours, e.g. promoting tobacco smoking cessation or discouraging the use of illicit drugs or excessive drinking....

 within chest pain clinics across England. OMA looks at ways of improving the care of people suffering with angina as well as exploring the reasons why treatment received varies.

Objectives

• To determine the cumulative impact on patient outcome of missed opportunities for improving patient outcome, from the beginning to the end of the patient journey, across five of the most common symptomatic coronary presentations, assessing inequalities in care and outcome.

• To determine at the level of the individual hospital the extent to which the organisation and processes of care have an impact on the patient journey. We will assess how variations measured at hospital level are impacted by the quality of primary care.

• To establish the effectiveness and cost-effectiveness of a multi-faceted intervention targeting initial specialist management at hospital chest pain clinics of patients early in the symptomatic phase of the patient journey.

• To determine whether novel biomarkers are a cost-effective addition to existing clinical information in predicting the progression of chronic stable angina to acute fatal and non-fatal events.

Collaborators

OMA is a collaboration between:

• University College London
  University College London
  University College London is a public research university located in London, United Kingdom and the oldest and largest constituent college of the federal University of London...
  
  
• University of Bristol
  University of Bristol
  The University of Bristol is a public research university located in Bristol, United Kingdom. One of the so-called "red brick" universities, it received its Royal Charter in 1909, although its predecessor institution, University College, Bristol, had been in existence since 1876.The University is...
  
  
• Queen Mary, University of London
  Queen Mary, University of London
  Queen Mary, University of London is a public research university located in London, United Kingdom and a constituent college of the federal University of London...
  
  

Funding

OMA is funded by the NHS

National Health Service (England)

The National Health Service or NHS is the publicly funded healthcare system in England. It is both the largest and oldest single-payer healthcare system in the world. It is able to function in the way that it does because it is primarily funded through the general taxation system, similar to how...

National Institute of Health Research (NIHR)