Mailed Reminders Encourage Heart Attack Patients to Take Medicine

Mailing patients who have suffered a heart attack an easy-to-read, personal reminder can increase the odds that they will continue to take their necessary beta-blocker medication, new research says.

More than 7 million American adults have had a heart attack, and treatment guidelines encourage these patients to take a beta-blocker medication — such as Tenormin or Lopressor — to increase their chances of survival. Although doctors routinely prescribe beta-blockers to these patients, many stop taking the medication over time.

Researchers of the new study, appearing in the March 10 issue of the Archives of Internal Medicine, wanted to see if patients who received a personalized letter from their health plan reminding them to take their medication would be more likely to do so. They found patients were indeed 17 percent more likely to follow to their beta-blocker therapy after receiving the patient literature.

“Our hope was closer to a 10 percent increase, so our finding that patients were 17 percent more likely to be adherent using such a low-cost communication method is very encouraging,” said David H. Smith, Ph.D., who led the group of researchers from the Kaiser Permanente Center for Health Research in Portland, Ore.

Smith and his colleagues evaluated 836 patients who had had a heart attack in the past year of the study, which took place at four health maintenance organizations across the country from June 2004 to March 2005. The study participants received two mailings, two months apart.

The researchers used the proportion of days patients took their beta-blocker medication — considered “days covered”— as the main outcome measure. The study found patients who received direct-to-patient communication had an increase of 4.3 percent days covered per month compared to patients in the control group.

What seemed to be the biggest motivating factor for those patients?

“We think a key was the inclusion of a wallet-size card and personalized letter with specific messages regarding both the benefits of beta-blocker therapy and the risk of not taking them,” Smith said. “We also emphasized the importance of patients talking with their doctor about side effects and other treatments that might be beneficial.”

Samuel Sears, Ph.D., director of the Health Psychology Program at East Carolina University in Greenville, N.C., agreed these types of patient mailings are worthwhile.

“Direct-to-patient communication is a modern strategy employed by other entities related to patient health, such as pharmaceutical makers, because it has some effectiveness,” he said. “Health care organizations use these newsletter tools as informational and relationship-building, [and] the current study provides evidence that they have clinical utility.”

The Agency for Healthcare Research and Quality provided support for this study.