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February 13, 2018

Improving Evidence for Implementation of Guideline-Based Care in Low- and Middle-Income Countries

Author Affiliations
  • 1Duke Clinical Research Institute, Durham, North Carolina
  • 2St John’s Medical College and Research Institute, Bangalore, India
JAMA. 2018;319(6):554-556. doi:10.1001/jama.2017.21905

Coronary heart disease is the number one cause of death and disability in India and around the world.1 Evidence-based approaches for prevention and treatment of coronary heart disease are widely available but are not used optimally, particularly in low- and middle-income countries.2,3 In India, like in many countries, there are major gaps between actual and ideal care, and quality of care is substantially worse for patients with low socioeconomic status.4 Studies of quality improvement in Brazil,5 China,6 and India7 have been associated with improvements in acute coronary syndrome care5-7 and in clinical outcomes.7 However, there is an important need to further develop approaches to improve implementation of evidence-based care in these countries.