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Rationale and design of the Affordability and Real-world Antiplatelet Treatment Effectiveness after Myocardial Infarction Study (ARTEMIS): A multicenter, cluster-randomized trial of P2Y12 receptor inhibitor copayment reduction after myocardial infarction.

Publication ,  Journal Article
Doll, JA; Wang, TY; Choudhry, NK; Cannon, CP; Cohen, DJ; Fonarow, GC; Henry, TD; Bhandary, DD; Khan, N; Davidson-Ray, LD; Anstrom, K; Peterson, ED
Published in: Am Heart J
July 2016

BACKGROUND: The use of oral P2Y12 receptor inhibitors after acute myocardial infarction (MI) can reduce risks of subsequent major adverse cardiovascular events (composite of all-cause death, recurrent MI, and stroke), yet medication persistence is suboptimal. Although copayment cost has been implicated as a factor influencing medication persistence, it remains unclear whether reducing or eliminating these costs can improve medication persistence and/or downstream clinical outcomes. DESIGN: ARTEMIS is a multicenter, cluster-randomized clinical trial designed to examine whether eliminating patient copayment for P2Y12 receptor inhibitor therapy affects medication persistence and clinical outcomes. We will enroll approximately 11,000 patients hospitalized for acute ST-elevation and non-ST-elevation MI at 300 hospitals. Choice and duration of treatment with a P2Y12 receptor inhibitor will be determined by the treating physician. Hospitals randomized to the copayment intervention will provide vouchers to cover patients' copayments for their P2Y12 receptor inhibitor for up to 1 year after discharge. The coprimary end points are 1-year P2Y12 receptor inhibitor persistence and major adverse cardiovascular events. Secondary end points include choice of P2Y12 receptor inhibitor, patient-reported outcomes, and postdischarge cost of care. CONCLUSION: ARTEMIS will be the largest randomized assessment of a medication copayment reduction intervention on medication persistence, clinical outcomes, treatment selection, and cost of care after acute MI.

Duke Scholars

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

July 2016

Volume

177

Start / End Page

33 / 41

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Ticlopidine
  • Ticagrelor
  • Stroke
  • Secondary Prevention
  • Recurrence
  • Purinergic P2Y Receptor Antagonists
  • Myocardial Infarction
  • Multivariate Analysis
  • Mortality
 

Citation

APA
Chicago
ICMJE
MLA
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Doll, J. A., Wang, T. Y., Choudhry, N. K., Cannon, C. P., Cohen, D. J., Fonarow, G. C., … Peterson, E. D. (2016). Rationale and design of the Affordability and Real-world Antiplatelet Treatment Effectiveness after Myocardial Infarction Study (ARTEMIS): A multicenter, cluster-randomized trial of P2Y12 receptor inhibitor copayment reduction after myocardial infarction. Am Heart J, 177, 33–41. https://doi.org/10.1016/j.ahj.2016.04.008
Doll, Jacob A., Tracy Y. Wang, Niteesh K. Choudhry, Christopher P. Cannon, David J. Cohen, Gregg C. Fonarow, Timothy D. Henry, et al. “Rationale and design of the Affordability and Real-world Antiplatelet Treatment Effectiveness after Myocardial Infarction Study (ARTEMIS): A multicenter, cluster-randomized trial of P2Y12 receptor inhibitor copayment reduction after myocardial infarction.Am Heart J 177 (July 2016): 33–41. https://doi.org/10.1016/j.ahj.2016.04.008.
Doll JA, Wang TY, Choudhry NK, Cannon CP, Cohen DJ, Fonarow GC, Henry TD, Bhandary DD, Khan N, Davidson-Ray LD, Anstrom K, Peterson ED. Rationale and design of the Affordability and Real-world Antiplatelet Treatment Effectiveness after Myocardial Infarction Study (ARTEMIS): A multicenter, cluster-randomized trial of P2Y12 receptor inhibitor copayment reduction after myocardial infarction. Am Heart J. 2016 Jul;177:33–41.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

July 2016

Volume

177

Start / End Page

33 / 41

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Ticlopidine
  • Ticagrelor
  • Stroke
  • Secondary Prevention
  • Recurrence
  • Purinergic P2Y Receptor Antagonists
  • Myocardial Infarction
  • Multivariate Analysis
  • Mortality