Acute Myocardial Infarction (AMI) Clinical Trial
Official title:
The HMO Research Network CERT: Acute Myocardial Infarction
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.
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).
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Health Services Research
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