Delayed Educational Reminders in Acute Myocardial Infarction (MI)
- Conditions
- Acute Myocardial InfarctionSTEMI
- Interventions
- Behavioral: Educational Reminder
- Registration Number
- NCT01325116
- Lead Sponsor
- Hamilton Health Sciences Corporation
- Brief Summary
ST segment elevation myocardial infarction (STEMI) is a common presentation of heart attack constituting approximately 30% of all cases. Clinical guidelines around the world support the prolonged use of secondary preventative medications including aspirin, clopidogrel, statin, beta-blocker and angiotensin blockers with the highest recommendations. While in-hospital and discharge prescription rates are excellent, adherence to these essential life-saving medications is far less than ideal, even a few months following hospital discharge. The investigators plan to capitalize on the existing structure of the SMART-AMI project already underway in LHIN IV to undertake a randomized controlled trial evaluating a reminder sent on behalf of the interventional cardiologists, delivered by mail, at 1, 2, 5, 8, and 11-months post-discharge, reviewing the evidence for life-saving cardiac medications and urging long-term adherence to secondary preventative cardiac medications. This will be sent to the family physician and the patient, using audience-appropriate language. If the DERLA-STEMI project is accepted by physicians and patients, found to be both feasible and effective, then this simple and low-cost intervention will be studied in all patients with an abnormal coronary angiogram.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 852
- Admitted with STEMI to a hospital in LHIN IV, coronary angiogram with and without PCI at Hamilton General Hospital during hospital admission
- Non-english speaking
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Control Educational Reminder Usual post-STEMI care Intervention Educational Reminder Recurrent, personalized, educational reminders sent via post on behalf of the interventional cardiologist to the patient and their family physician urging long-term adherence to secondary prevention medications post-STEMI. A copy of the letter will be provided to the patient to take to their pharmacist.
- Primary Outcome Measures
Name Time Method Cardiac Medication Use 3 and 12 months Proportion of patients who report taking all cardiac medication classes, measured three and twelve months post-STEMI. Specifically, we will assess whether patients are taking a statin, beta-blocker, angiotensin modifier (ACE or ARB), and aspirin at twelve months, and whether they are taking these plus a secondary antiplatelet (clopidogrel, prasugrel, or ticagrelor) at three months.
- Secondary Outcome Measures
Name Time Method Adherence 3 and 12 Months Proportion of patients with a perfect Morisky Green Levine Test for cardiac medication compliance at three and twelve months.
Statin Dose 3 and 12 months Proportion of patients taking high dose statins at three and twelve months
Use of medication combinations 3 and 12 months The proportion of patients using 1 of 5, 2 of 5, 3 of 5, 4 of 5, or 5 of 5 medications at three and twelve months.
Medication Side-effects 3 and 12 months Proportion of patients who report stopping medications due to side effects at three and twelve months
Other Evidence-based Cardiac Medication Use 3 and 12 months Proportion of patients who report actively taking aspirin, clopidogrel, statin, beta-blocker, and/or angiotensin blocker
Discussion with Family physician/specialist 3 and 12 months Proportion of patients who state that they had a discussion with their FP regarding the benefits of certain medications to prevent future heart attacks or that focused on medication compliance since their heart attack.
Trial Locations
- Locations (1)
Hamilton Health Sciences-General Site, Heart Investigation Unit
🇨🇦Hamilton, Ontario, Canada