Health IT, Hospitals

Study: Medication adherence improved with proper prompts

Patients who received automated reminders were more likely to refill their blood pressure and cholesterol […]

Patients who received automated reminders were more likely to refill their blood pressure and cholesterol medications, according to a study published in the American Journal of Managed Care that looked at medication adherence efforts.

The study, which included more than 21,000 Kaiser Permanente members, found that the average improvement in medication adherence was only about 2 percentage points,but the authors said that in a large population, even small changes can make a big difference.

“This small jump might not mean a lot to an individual patient, but on a population levelit could translate into fewer heart attacks, fewer deaths and fewer hospitalizations, which will ultimately have an important impact on public health,” Dr. Bill Vollmer lead author and senior investigator at the Kaiser Permanente Center for Health Research in Portland, Ore, said in a release.

In fact, Vollmer said that even though the study lasted only a year, patients who received both telephone and mailed reminders, saw improvements in their cholesterol levels that could lead to improved health outcomes if sustained.

According to a recent federal report, Americans with chronic conditions take their medications as prescribed about 50 to 60 percent of the time. The report estimates that this phenomenon costs the health care system as much as $300 billion each year, and results in about 125,000 deaths.

The industry as a whole is trying to get a handle on medication adherance, with scores of startups and health systems applying data analytics and varying degrees of prompts and intervention.

But, according to Vollmer, sometimes the simple efforts like a text prompt can be more effective, depending on the target.

The study took place in 2010-2011 and enrolled some 21,700 Kaiser Permanente members across Oregon, Washington, Georgia and Hawaii who had diabetes or heart disease and were taking medications.

Using Kaiser’s EHR, researchers identified patients who were either overdue or soon-to-be due to refill a prescription for a statin,ACE inhibitor or angiotensin receptor blocker.

The study, which examined the PROMPT reminder program, had three arms: usual care, an automated telephone call intervention, and an enhanced intervention that included reminder letters and live calls for those who didn’t respond to the automated calls, as well as personalized health reports and educational mailings.

The interactive voice calls lasted about 2-3 minutes, reminding patients to refill their prescription and then giving them an option to be transferred to an automated refill line, or in some cases, to speak with a pharmacist.

At the beginning of the study, participants were taking their medications a little more than half the time. Adherence levels went up among all participants, but they increased by more (1.6-3.7 percentage points) among participants who received the reminder, according to the study.

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