Evidence map›Paper›PMID 35725542›Full record

ArticleBMC medicine2022

Length of initial prescription at hospital discharge and long-term medication adherence for elderly, post-myocardial infarction patients: a population-based interrupted time series study.

J D Schwalm, Noah M Ivers, Zachary Bouck, Monica Taljaard, Madhu K Natarajan, Francis Nguyen, Waseem Hijazi, Kednapa Thavorn, Lisa Dolovich, Tara McCready and 2 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03257579 (Length of Initial Prescription at Hospital Discharge and Long-term Medication Adherence for Elderly Patients Post-Myocardial Infarction), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03257579 nacompletednot on this map

Length of Initial Prescription at Hospital Discharge and Long-term Medication Adherence for Elderly Patients Post-Myocardial Infarction: An Interventional Study

TypeinterventionalSponsorHamilton Health Sciences CorporationRan2017 to 2021Enrolled20,896ConditionsMedication AdherenceArms90 Day Supply, Education
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Not obtaining a medication the first time it is prescribed: primary non-adherence to cardiovascular pharmacotherapy.Clinical research in cardiology : official journal of the German Cardiac Society · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 1 country.

J D Schwalm *Population Health Research Institute, McMaster University and Hamilton Health Sciences, DBCVSRI, 237 Barton Street East, Hamilton, ON, L8L 2X2, Canada. schwalj@mcmaster.ca.
Noah M Ivers *Family Practice Health Centre, Women's College Hospital, Toronto, ON, Canada.
Zachary BouckEpidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Monica TaljaardClinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
Madhu K NatarajanPopulation Health Research Institute, McMaster University and Hamilton Health Sciences, DBCVSRI, 237 Barton Street East, Hamilton, ON, L8L 2X2, Canada.
Francis NguyenICES, Toronto, ON, Canada.
Waseem HijaziDivision of Cardiology, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Kednapa ThavornICES, Toronto, ON, Canada.
Lisa DolovichLeslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
Tara McCreadyPopulation Health Research Institute, McMaster University and Hamilton Health Sciences, DBCVSRI, 237 Barton Street East, Hamilton, ON, L8L 2X2, Canada.
Erin O'BrienPopulation Health Research Institute, McMaster University and Hamilton Health Sciences, DBCVSRI, 237 Barton Street East, Hamilton, ON, L8L 2X2, Canada.
Jeremy M GrimshawClinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
University of Ottawa · CAUniversity of Toronto · CAMcMaster University · CAPopulation Health Research Institute · CAHamilton Health Sciences · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPreliminary evidence suggests that providing longer duration prescriptions at discharge may improve long-term adherence to secondary preventative cardiac medications among post-myocardial infarction (MI) patients. We implemented and assessed the effects of two hospital-based interventions-(1) standardized prolonged discharge prescription forms (90-day supply with 3 repeats for recommended cardiac medications) plus education and (2) education only-on long-term cardiac medication adherence among elderly patients post-MI.

methodsWe conducted an interrupted time series study of all post-MI patients aged 65-104 years in Ontario, Canada, discharged from hospital between September 2015 and August 2018 with ≥ 1 dispensation(s) for a statin, beta blocker, angiotensin system inhibitor, and/or secondary antiplatelet within 7 days post-discharge. The standardized prolonged discharge prescription forms plus education and education-only interventions were implemented at 2 (1,414 patients) and 4 (926 patients) non-randomly selected hospitals in September 2017 for 12 months, with all other Ontario hospitals (n = 143; 18,556 patients) comprising an external control group. The primary outcome, long-term cardiac medication adherence, was defined at the patient-level as an average proportion of days covered (over 1-year post-discharge) ≥ 80% across cardiac medication classes dispensed at their index fill. Primary outcome data were aggregated within hospital groups (intervention 1, 2, or control) to monthly proportions and independently analyzed using segmented regression to evaluate intervention effects. A process evaluation was conducted to assess intervention fidelity.

resultsAt 12 months post-implementation, there was no statistically significant effect on long-term cardiac medication adherence for either intervention-standardized prolonged discharge prescription forms plus education (5.4%; 95% CI - 6.4%, 17.2%) or education only (1.0%; 95% CI - 28.6%, 30.6%)-over and above the counterfactual trend; similarly, no change was observed in the control group (- 0.3%; 95% CI - 3.6%, 3.1%). During the intervention period, only 10.8% of patients in the intervention groups received ≥ 90 days, on average, for cardiac medications at their index fill.

conclusionsRecognizing intervention fidelity was low at the pharmacy level, and no statistically significant post-implementation differences in adherence were found, the trends in this study-coupled with other published retrospective analyses of administrative data-support further evaluation of this simple intervention to improve long-term adherence to cardiac medications.

trial registrationClinicalTrials.gov : NCT03257579 , registered June 16, 2017 Protocol available at: https://pubmed.ncbi.nlm.nih.gov/33146624/ .

Indexed as

Myocardial InfarctionPatient DischargeAftercareAgedHospitalsHumansInterrupted Time Series AnalysisMedication AdherenceOntarioPrescriptionsRetrospective StudiesAdherencePolicy changePost-myocardial infarctionSecondary preventionStandardized discharge prescription form

Identifiers

PMID35725542
PMCPMC9210591
OpenAlexW4283218475

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.