Evaluating the impact of public health notification: Duke clopidogrel experience

Eric L. Eisenstein, Daniel Wojdyla, Kevin J. Anstrom, J. Matthew Brennan, Robert M. Califf, Eric D. Peterson, Pamela S. Douglas

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background-Provider and public health interventions in the late 2006 sought to change the duration of clopidogrel use after drug-eluting stent (DES) implantation. We evaluated whether public health interventions were associated with changes in patient-reported clopidogrel use among DES patients. Methods and Results-We used interrupted time analyses to evaluate trends in duration of patient-reported clopidogrel use before, during, and after public and provider interventions. We included patients with significant coronary artery disease receiving an intracoronary stent between April 2004 and December 2007 at a single tertiary care center. The center supplemented national and regulatory messaging regarding the role of clopidogrel after DES implantation with direct-to-patient and to-their-provider notifications in December 2006. The combination of public and provider direct notification was associated with significant changes in the percent of DES patients reporting clopidogrel use at 6 months (16.55% increase, P=0.010) and 12 months (15.33% increase, P=0.004), but no change at 24-month follow-up (4.64, P=0.295). During the same period, there was no change in the percent of bare-metal stent patients reporting clopidogrel use at 6-month (-3.73%, 0.654), 12-month (-5.98%, P=0.389), and 24-month follow-up (-5.16, P=0.708). Although mortality rates through 24 months seemed to decrease between the pre- and postintervention periods, these changes were not significant (DES, P=0.086; bare-metal stent, P=0.296). Conclusions-The combination of national scientific and regulatory messaging supplemented by local, personal communications to DES patients and their primary healthcare providers was associated with a significant increase in patient-reported clopidogrel use.

Original languageEnglish (US)
Pages (from-to)767-774
Number of pages8
JournalCirculation: Cardiovascular Quality and Outcomes
Issue number6
StatePublished - Nov 2012
Externally publishedYes


  • Angioplasty
  • Antiplatelet
  • Clopidogrel
  • Follow-up studies
  • Population
  • Stents

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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