In an editor’s note, Dr. Rita F. Redberg called the work "interesting and careful," and noted that the findings demonstrate an absolute increase of 11% in adherence to statins, ACE inhibitors, and angiotensin receptor blockers, and a 3% increase in adherence to beta-blockers.
The cost estimate of $360/patient is based on the "relatively lower costs of services in the VA system," but if applied to every patient with acute coronary syndrome in the United States (about 2.5 million annually, by recent estimates), the costs of such an intervention would add $1 billion annually to health care costs, she noted.
"For many reasons, the relatively modest increases in already high rates of medication regimen adherence in the patients studied may not translate into improved outcomes even if maintained for 3-5 years or longer. Of course, we hope that they do. But before recommending investment in this strategy, it would be prudent to know that patient outcomes will actually improve," she wrote.
Dr. Redberg of the department of medicine and women’s cardiovascular services at the University of California, San Francisco, is editor of JAMA Internal Medicine.
