For patients who have had a myocardial infarction (MI) and coronary artery disease, guidelines recommend cardiac rehabilitation services and the long‐term use of cardiac medications to reduce the risk of recurrent cardiovascular events. These treatments are proven to improve quality of life and reduce the risk of repeat heart attacks or death among persons who have already had one heart attack.

However, research shows that many people who have had a heart attack do not stick with these treatments and therefore cannot benefit from them.

The ISLAND-ACS study was a quality improvement research program that sought to understand the impact of low-cost interventions that could be readily implemented at scale by entire health systems or organizations wishing to improve adherence to proven treatments.

Specifically, the trial tested whether providing Ontario‐based patients (and their health professionals) with repeated educational reminders delivered via post and phone will help improve the medication adherence and attendance at cardiac rehabilitation.

The trial team partnered in this project with health system decision makers who have an interest in using the results to create standard operating procedures that could benefit patients across the province.

Furthermore, ISLAND-ACS has the potential to inform how other health databases could be used to improve health system performance.
Dr. Noah Ivers, Toronto

Co-Principal Investigator was Noah Ivers, at the Women’s College Hospital in Toronto, Canada.


Study Type

Interventional - Educational/Policy

Study Design

Pragmatic RCT, blinded outcome assessment

NO. of Countries


NO. of Sites


NO. of Participants


Study Period

2015 - 2017

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