Patient-centered adherence intervention after acute coronary syndrome hospitalization.

dc.contributor.author

Lambert-Kerzner, Anne

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Del Giacco, Eric J

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Fahdi, Ibrahim E

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Bryson, Chris L

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Melnyk, S Dee

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Bosworth, Hayden B

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Davis, Ryan

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Mun, Howard

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Weaver, Jennifer

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Barnett, Casey

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Radcliff, Tiffany

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Hubbard, Amanda

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Bosket, Kevin D

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Carey, Evan

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Virchow, Allison

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Mihalko-Corbitt, Renee

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Kaufman, Amy

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Marchant-Miros, Kathy

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Ho, P Michael

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Multifaceted Intervention to Improve Cardiac Medication Adherence and Secondary Prevention Measures (Medication) Study Investigators

dc.date.accessioned

2024-02-01T16:45:09Z

dc.date.available

2024-02-01T16:45:09Z

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2012-07

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Background

Adherence to cardioprotective medications in the year after acute coronary syndrome hospitalization is generally poor and is associated with increased risk of rehospitalization and mortality. Few interventions have specifically targeted this high-risk patient population to improve medication adherence. We hypothesize that a multifaceted patient-centered intervention could improve adherence to cardioprotective medications.

Methods and results

To evaluate this intervention, we propose enrolling 280 patients with a recent acute coronary syndrome event into a multicenter randomized, controlled trial. The intervention comprises 4 main components: (1) pharmacist-led medication reconciliation and tailoring; (2) patient education; (3) collaborative care between pharmacist and primary care provider/cardiologist; and (4) 2 types of voice messaging (educational and medication refill reminder calls). Patients in the intervention arm will visit with the study pharmacist ≈1 week post-hospital discharge. The pharmacist will work with the patient and collaborate with providers to reconcile medication issues. Voice messages will augment the educational process and remind patients to refill their cardioprotective medications. The study will compare the intervention versus usual care for 12 months. The primary outcome of interest is adherence using the ReComp method. Secondary and tertiary outcomes include achievement of targets for blood pressure and low-density lipoprotein, and reduction in the combined cardiovascular end points of myocardial infarction hospitalization, coronary revascularization, and all-cause mortality. Finally, we will also evaluate the cost-effectiveness of the intervention compared with usual care.

Conclusions

If the intervention is effective in improving medication adherence and demonstrating a lower cost, the intervention has the potential to improve cardiovascular outcomes in this high-risk patient population.
dc.identifier

5/4/571

dc.identifier.issn

1941-7713

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1941-7705

dc.identifier.uri

https://hdl.handle.net/10161/30049

dc.language

eng

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Ovid Technologies (Wolters Kluwer Health)

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Circulation. Cardiovascular quality and outcomes

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10.1161/circoutcomes.111.962290

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https://creativecommons.org/licenses/by-nc/4.0

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Multifaceted Intervention to Improve Cardiac Medication Adherence and Secondary Prevention Measures (Medication) Study Investigators

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Humans

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Cardiovascular Agents

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Hospitalization

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Patient Discharge

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Patient Readmission

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Prospective Studies

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Health Knowledge, Attitudes, Practice

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Interdisciplinary Communication

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Cooperative Behavior

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Research Design

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Time Factors

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Reminder Systems

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Community Pharmacy Services

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Cost-Benefit Analysis

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Health Care Costs

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Patient-Centered Care

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Patient Care Team

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United States

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Patient Education as Topic

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Acute Coronary Syndrome

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Medication Adherence

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Medication Reconciliation

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Patient-centered adherence intervention after acute coronary syndrome hospitalization.

dc.type

Journal article

duke.contributor.orcid

Bosworth, Hayden B|0000-0001-6188-9825

pubs.begin-page

571

pubs.end-page

576

pubs.issue

4

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Duke

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School of Medicine

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Basic Science Departments

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Clinical Science Departments

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Institutes and Centers

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Medicine

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Psychiatry & Behavioral Sciences

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Medicine, General Internal Medicine

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Duke Cancer Institute

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Duke Clinical Research Institute

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Institutes and Provost's Academic Units

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Center for the Study of Aging and Human Development

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Initiatives

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Duke Science & Society

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Population Health Sciences

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Duke Innovation & Entrepreneurship

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Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences

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Duke - Margolis Center For Health Policy

pubs.publication-status

Published

pubs.volume

5

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