Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Delayed educational reminders for long-term medication adherence in ST-elevation myocardial infarction (DERLA-STEMI): Protocol for a pragmatic, cluster-randomized controlled trial
Implementation Science, Volume 7, No. 1, Article 54, Year 2012
Notification
URL copied to clipboard!
Description
Background: Despite evidence-based recommendations supporting long-term use of cardiac medications in patients post ST-elevation myocardial infarction, adherence is known to decline over time. Discontinuation of cardiac medications in such patients is associated with increased mortality.Methods/design: This is a pragmatic, cluster-randomized controlled trial with blinded outcome assessment and embedded qualitative process evaluation. Patients from one health region in Ontario, Canada who undergo a coronary angiogram during their admission for ST-elevation myocardial infarction and who survive their initial hospitalization will be included. Allocation of eligible patients to intervention or usual care will take place within one week after the angiogram using a computer-generated random sequence. To avoid treatment contamination, patients treated by the same family physician will be allocated to the same study arm. The intervention consists of recurrent, personalized, paper-based educational messages and reminders sent via post on behalf of the interventional cardiologist to the patient, family physician, and pharmacist urging long-term adherence to secondary prevention medications. The primary outcome is the proportion of patients who report in a phone interview taking all relevant classes of cardiac medications at twelve months. Secondary outcomes to be measured at three and twelve months include proportions of patients who report: actively taking each cardiac medication class of interest (item-by-item); stopping medications due to side effects; taking one or two or three medication classes concurrently; a perfect Morisky Medication Adherence Score for cardiac medication compliance; and having a discussion with their family physician about long-term adherence to cardiac medications. Self-reported measures of adherence will be validated using administrative data for prescriptions filled.Discussion: This intervention is designed to be easily generalizable. If effective, it could be implemented broadly. If it does not change medication utilization, the process evaluation will offer insights regarding how such an intervention could be optimized in future.Trial registration: Clinicaltrials.gov NCT01325116. © 2012 Ivers et al.; licensee BioMed Central Ltd.
Authors & Co-Authors
Schwalm, Jon David Reid
Canada, Hamilton
Mcmaster University
Grimshaw, Jeremy M.
Canada, Ottawa
L'hôpital D'ottawa
Witteman, Holly O.
United States, Ann Arbor
University of Michigan, Ann Arbor
Taljaard, Monica K.
Canada, Ottawa
L'hôpital D'ottawa
Zwarenstein, Merrick F.
Canada, Toronto
Institute for Clinical Evaluative Sciences
Natarajan, Madhu Kailash
Canada, Hamilton
Mcmaster University
Statistics
Citations: 7
Authors: 6
Affiliations: 5
Identifiers
Doi:
10.1186/1748-5908-7-54
ISSN:
17485908
Research Areas
Health System And Policy
Noncommunicable Diseases
Study Design
Randomised Control Trial
Study Approach
Qualitative
Quantitative