The drug, called a beta-blocker, should be prescribed for many patients
who have suffered a heart attack, according to national evidence-based
guidelines. Beta-blockers improve survival and lessen chances of second
heart attacks.
The research appears in the American Journal of Managed
Care.
Researchers from the University of Maryland, led by Ilene
H. Zuckerman, Pharm.D., sent educational packages to the doctors of 2,543
Pennsylvania
Medicaid patients. Package content varied slightly with each patient’s
status. But the full package went to 485 doctors identified as having
patients who should have been using beta-blockers but were not. Another
10,972 doctors
received a newsletter containing much of the same information, but not
tailored to specific patients.
The educational package included a letter about ways to
treat heart attack patients, the problems patients had in obtaining and
continuing to use
beta-blockers, and ways to increase the use of these drugs. Doctors of
patients who were not taking beta-blockers also received a list of the
patients’ pharmacy records.
After the mailings, heart attack survivors were 16 percent more likely
to be prescribed a beta-blocker, compared to patients before the intervention.
That effect may seem small, Zuckerman says, but it was statistically significant.
Because the number of patients involved was so large, there were important
benefits to even this one-shot intervention. Examination of pharmacy records
also showed that the number of patients filling their prescriptions increased
by 8.3 percent after the mailing, Zuckerman says.
The increased use of beta-blockers saved three lives,
she estimates, and reduced hospitalization and other costs, saving more
than $76,000 for
the Pennsylvania Medicaid system. There was probably also a spillover effect
to other patients and to doctors’ increased awareness of when to
use beta-blockers.
