Abstract
Background-Provider and public health interventions in the late 2006 sought to change the duration of clopidogrel use after drug-eluting stent (DES) implantation. We evaluated whether public health interventions were associated with changes in patient-reported clopidogrel use among DES patients. Methods and Results-We used interrupted time analyses to evaluate trends in duration of patient-reported clopidogrel use before, during, and after public and provider interventions. We included patients with significant coronary artery disease receiving an intracoronary stent between April 2004 and December 2007 at a single tertiary care center. The center supplemented national and regulatory messaging regarding the role of clopidogrel after DES implantation with direct-to-patient and to-their-provider notifications in December 2006. The combination of public and provider direct notification was associated with significant changes in the percent of DES patients reporting clopidogrel use at 6 months (16.55% increase, P=0.010) and 12 months (15.33% increase, P=0.004), but no change at 24-month follow-up (4.64, P=0.295). During the same period, there was no change in the percent of bare-metal stent patients reporting clopidogrel use at 6-month (-3.73%, 0.654), 12-month (-5.98%, P=0.389), and 24-month follow-up (-5.16, P=0.708). Although mortality rates through 24 months seemed to decrease between the pre- and postintervention periods, these changes were not significant (DES, P=0.086; bare-metal stent, P=0.296). Conclusions-The combination of national scientific and regulatory messaging supplemented by local, personal communications to DES patients and their primary healthcare providers was associated with a significant increase in patient-reported clopidogrel use.
Original language | English (US) |
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Pages (from-to) | 767-774 |
Number of pages | 8 |
Journal | Circulation: Cardiovascular Quality and Outcomes |
Volume | 5 |
Issue number | 6 |
DOIs | |
State | Published - Nov 2012 |
Externally published | Yes |
Keywords
- Angioplasty
- Antiplatelet
- Clopidogrel
- Follow-up studies
- Population
- Stents
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine