Culturally-Tailored Approach to Improve Medication Use in Patients With Heart Attacks

Completed · Not applicable

Conditions studied: Coronary Arteriosclerosis, Myocardial Infarction

In brief

Our research aims to improve the use of medicines known to prevent recurrent heart attacks. In particular, we know that statin treatment is useful after heart attacks, but many patients do not use it. There are a few possible reasons for this. Patients cannot find affordable medicine. Their doctor may not prescribe the medicine after they leave the hospital. Some people may culturally mistrust using the medicine. So they may decide not to take it even if it is prescribed. We are developing a hospital based culturally attuned program to target this problem. In this program, a community health worker counsels and helps patients in accessing pharmacy assistance programs. We will test whether this program can improve appropriate statin use. We will enroll patients who have heart attacks. We will compare patients who are counseled by the community health worker with those who get the usual care at baseline and at 6 and 12 months (participants enrolled during the early phase of the recruitment will have an additional study visit at 24 months). We will test if their "bad" cholesterol levels are controlled. We will find out how regularly they have filled their questionnaire and taken the medicine. Finally, we will test if they are getting benefit from the statin treatment. We will do this using blood tests and imaging the patients' arteries with ultrasound. We will also measure how cost-effective it is for a hospital to run the program. It is our goal to develop a community health worker model that is culturally sensitive for people with cultural, educational or educational barriers. Statin use is known to benefit patients in theory; such a culturally competent program will improve health outcomes in practice. After we test it, a cost-effective program such as this can be implemented in other hospitals.

Key facts

Study ID

NCT00426231

Run by

Johns Hopkins University

People needed

140

Starts

2006-03-01

Expected to finish

2009-12-01

Last updated by the study team

2014-02-24

Who can join

Age: 21 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Admitted to Johns Hopkins Hospital or Johns Hopkins Bayview Medical Center
• Diagnoses of Myocardial Infarction, unstable angina, percutaneous intervention, coronary artery bypass surgery
• One of the following:
• Less than a high school education (defined as completion of the 12th grade)
• No insurance for medications with a household income of $50,000. or less
• Any difficulty in co-pay even with a household income of >$50,000.

You may not qualify if…

• physician contraindicates statin use
• chronic glucocorticosteroid therapy
• autoimmune disease (i.e. lupus erythematosus)
• current chemotherapy or radiation
• immediate life-threatening comorbidity (i.e. HIV-AIDS, end-stage renal disease, or cancer)
• history of hepatic or renal failure
• myositis with creatine kinase (CK) elevations
• any prior adverse response to statin therapy
• statin allergy
• rhabdomyolysis
• pregnant women

Where it is running

• Johns Hopkins Hospital — Baltimore, Maryland, United States

Full record on ClinicalTrials.gov

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