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Strategies to increase the use of evidence-based medications to improve outcomes after acute MI typically target clinicians. However, the promise of such therapies is also limited by the failure of many patients to take their prescribed medications. Interventions designed to improve adherence to medications are usually multimodal, and identifying which of their components are most effective has been a challenge.
The present study included 836 survivors of acute MI (67% male; average age, 65; average time from MI to randomization, about 136 days) in four U.S. managed healthcare systems. In three systems, patients were cluster-randomized at the practice level; in the fourth, individual patients were randomized. Focus groups were used to develo…