HMO Research Network CERT: Acute Myocardial Infarction
- Conditions
- Acute Myocardial Infarction (AMI)
- Interventions
- Behavioral: Beta-blocker adherence after an AMI
- Registration Number
- NCT00211172
- Lead Sponsor
- Kaiser Permanente
- Brief Summary
The primary goal of this study is to evaluate the effectiveness of direct-to-patient mailings designed to increase patient's adherence to prescribed beta-blockers following an acute myocardial infarction (AMI).
Prior to developing patient materials, focus groups were conducted with patient who had previously suffered an acute myocardial infarction (AMI) to identify the issues and information that patients felt were important to include in our materials as well as the best way to present the information. Additionally, patient materials were "pre-tested" with AMI patients to ensure that the materials were clear and easy to read and that the key messages were understood.
- Detailed Description
Specific Aims:
1. Assess the persistence of beta blocker use for post-acute myocardial infarction (AMI) patients following a direct to patient intervention designed to increase rates of evidence-based long-term use of medications (beta blockers, lipid lowering agents, aspirin and ACE inhibitors) that increase survival following AMI.
2. Describe patient and system characteristics associated with differences in impact of the intervention
Research Design and Methods:
We will conduct a randomized controlled trial within the 4 participating HMOs (Kaiser Permanente Northwest, Harvard Pilgrim Health Care, Health Partners, and Kaiser Permanente Georgia). Inpatient data will be used to identify patients with a primary discharge diagnosis of AMI 4-6 months before the extraction date. Practices will be block-randomized to the intervention group or to usual care. To increase repetition of the message, there will be two personalized mailings, occurring at 4-6 months post AMI, and at 9 months. The first message will include elements in the table below, and the repeat message will be shorter, but include similar information. The message will come from the patient's own health plan with the choice of specific individual (e.g. quality assurance department, medical director, or Chief of Cardiology) being informed by our qualitative work. This intervention will be done in collaboration with the cardiovascular care committees and quality assurance departments of participating Health Maintenance Organizations (HMOs).
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 836
- Clinical diagnosis of Acute Myocardial Infarction (AMI) from 12/1/03 to 5/31/04
- Beta-blocker dispensing following AMI
- Beta-blocker dispensing prior to intervention date
None
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Beta-blocker adherence after an AMI Beta-blocker adherence after an AMI Patients received two mailings about the importance of beta blocker use.
- Primary Outcome Measures
Name Time Method Adjusted Mean Monthly Percent of Days Covered With B-blocker Following Intervention Date 9 months The primary outcome measure adherence to B-blocker therapy post intervention. Adherence was measured by the degree of prescription filling in an interval derived from pharmacy prescription records by constructing a proportion-of-days-covered per-month measure, using the quantity dispensed and days supplied from each prescription
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (4)
Health Partners
🇺🇸Minneapolis, Minnesota, United States
Kaiser Permanent Center for Health Research
🇺🇸Portland, Oregon, United States
Harvard Pilgrim Healthcare
🇺🇸Boston, Massachusetts, United States
Kaiser Permanente-Georgia
🇺🇸Atlanta, Georgia, United States