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Phone calls after DES implantation improved 1-year DAPT adherence
Four telephone calls to patients following drug-eluting stent implantation improved 1-year dual antiplatelet therapy adherence to near-perfect scores, according to results of the EASY-IMPACT trial.
The results were initially presented at the 2012 Society for Cardiovascular Angiography and Interventions Scientific Sessions and published recently in Heart.
For the EASY-IMPACT trial, researchers randomly assigned 300 patients following DES implantation to either an intervention group that received four telephone follow-up calls — first within 7 days of the procedure and again at 1, 6 and 9 months to support drug adherence — or to a control group that was followed per usual clinic practice.
Median scores and the 25th to 75th percentile range were assessed for adherence at 12 months. In the intervention group, median adherence to aspirin was 99.2% and the range was 97.5% to 100%, and median adherence to clopidogrel was 99.3% and the range was 97.5% to 100%. In the control group, median adherence for aspirin was 90.2% with a range of 84.2% to 95.4%, and median adherence for clopidogrel was 91.5% with a range of 85.1% to 96%.
Patients in the intervention group were more persistent in continuing the aspirin and clopidogrel treatments than those in the control group. For clopidogrel, 87.2% of patients in the intervention group continued the regimen at 12 months compared with only 43.1% in the control group (P<.0001).
“The intervention also had a favorable effect on adherence to statin therapy. Persistence was also greatly improved with the intervention,” the researchers wrote. “Finally, most patients in both groups reported taking [DAPT] appropriately, even at 1 year; self-reported compliance clearly and grossly overestimated the true medication refill-adherence status in our study, with very low agreement with actual pharmacy data. This finding strongly questions the value of using patients’ reports on drug compliance.”
Disclosure: The researchers report no relevant financial disclosures.