Aims  The aim of this study was to determine the contemporary use of reperfusion therapy in the European Society of Cardiology (ESC) member and affiliated countries and adherence to ESC clinical practice guidelines in patients with ST-elevation myocardial infarction (STEMI). Methods and results  Prospective cohort (EURObservational Research Programme STEMI Registry) of hospitalized STEMI patients with symptom onset <24 h in 196 centres across 29 countries. A total of 11 462 patients were enrolled, for whom primary percutaneous coronary intervention (PCI) (total cohort frequency: 72.2%, country frequency range 0–100%), fibrinolysis (18.8%; 0–100%), and no reperfusion therapy (9.0%; 0–75%) were performed. Corresponding in-hospital mortality rates from any cause were 3.1%, 4.4%, and 14.1% and overall mortality was 4.4% (country range 2.5–5.9%). Achievement of quality indicators for reperfusion was reported for 92.7% (region range 84.8–97.5%) for the performance of reperfusion therapy of all patients with STEMI <12 h and 54.4% (region range 37.1–70.1%) for timely reperfusion. Conclusions  The use of reperfusion therapy for STEMI in the ESC member and affiliated countries was high. Primary PCI was the most frequently used treatment and associated total in-hospital mortality was below 5%. However, there was geographic variation in the use of primary PCI, which was associated with differences in in-hospital mortality.

The aims of this study were to determine whether the introduction of a diabetes management e‐module can increase junior doctors' confidence in managing inpatients with diabetes and contribute to improvements in patient care.A diabetes e‐module was introduced at Barnet and Chase Farm Hospitals NHS Trust in October 2010. Junior doctors completed it and undertook an online exam at the end. Junior doctors were surveyed once, six to eight months after completing the e‐module, and retrospectively ranked their confidence and knowledge levels in managing inpatients with diabetes before and after completing the e‐module. Patient care was assessed by comparing the National Diabetes Inpatient Audit (NaDIA) findings at Barnet Hospital before and at two time points after the introduction of the e‐module.After undertaking the e‐module there were statistically significant increases in the self‐ranked confidence and knowledge levels of junior doctors regarding diabetes management. This included improvements in identifying different types of insulin, making insulin dose adjustments for hypoglycaemia/hyperglycaemia and a reduction in reported prescription errors. The results from the NaDIA also suggest an improvement in ‘good diabetes days’ for insulin‐treated patients with diabetes and a pattern of reduction in prescription and management errors.This study demonstrates that an inpatient diabetes management e‐module increases junior doctors' knowledge and confidence in managing diabetes. A multi‐centre study would be needed to confirm whether this translates into better management of inpatients with diabetes. E‐modules may be used to cover further topics in diabetes, and to support nursing and patient education. Copyright © 2013 John Wiley & Sons. Practical Diabetes 2013; 30(3): 122–127