Helping Heart Patients Remember Meds

Acute coronary syndrome patients improve drug compliance with reminders and checklists

(RxWiki News) Following hospitalization, heart patients may do significantly better in remembering to take their medications with intervention that includes reminders, checklists and educational materials.

The patients, which had received treatment for acute coronary syndrome (ACS), found that the improvement occurred over the first 24 hours following hospitalization. ACS references a group of symptoms (mostly chest pain, pressure, sweating) associated with blocked coronary arteries. Most often the condition develops after a heart attack.

"Don't downplay chest pain. Call 9-1-1 immediately."

Dr. Otávio Berwanger, of the Research Institute HCor–Hospital do Coração in Brazil,noted in the study that altering clinical behavior to improve care quality is challenging. Previous reviews have suggested some quality improvement tools may be associated with better care, but such interventions have rarely been rigorously evaluated.

Researchers enrolled 1,150 ACS patients from 34 public hospitals in Brazil from March 2011 through November 2011. They were followed through January 2012. The average patient age was 62, and 69 percent of participants were men.

During the randomized  trial, one group of patients received reminders and checklists, while educational materials were provided for clinicians, and case manager training also was provided. The control group received routine care in the first 24 hours.

They measured the success or failure of the quality program by determining the number of patients who took evidence based therapies such as aspirin and blood pressure medications during the first 24 hours.

They found that patients who received intervention were significantly more likely to follow through in taking their acute therapies, with 68 percent of intervention patients taking the appropriate drugs as compared to 50 percent of patients who received the traditional standard of care following hospitalization. In addition, 51 percent in the intervention group followed through on evidence-based therapies versus 32 percent in the other group.

Patients from the intervention group also were slightly less likely to die within 30 days, with 7 percent from the intervention group dying within the first month of hospitalization as compared to 8.4 percent in the control group.

The research was presented Sunday at the American College of Cardiology's annual scientific sessions. It also was simultaneously published in the Journal of the American Medical Association.

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Review Date: 
March 25, 2012