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J Gen Intern Med. 2017 Mar;32(3):256-261. doi: 10.1007/s11606-016-3858-0. Epub 2016 Sep 9.

Patient and Partner Feedback Reports to Improve Statin Medication Adherence: A Randomized Control Trial.

Author information

1
Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA, USA. reddya@uw.edu.
2
UW Medicine Center for Scholarship in Patient Care Quality and Safety, Seattle, WA, USA. reddya@uw.edu.
3
Department of Medicine, University of Washington School of Medicine, 1959 NE Pacific Street, Suite BB1240, Box: 356526, Seattle, WA, 98195-6526, USA. reddya@uw.edu.
4
VISN 4 Center for Evaluation of PACT, Philadelphia VA Medical Center, Philadelphia, PA, USA.
5
School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA, USA.
6
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
7
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.

Abstract

BACKGROUND:

Simple nudges such as reminders and feedback reports to either a patient or a partner may facilitate improved medication adherence.

OBJECTIVE:

To test the impact of a pill bottle used to monitor adherence, deliver a daily alarm, and generate weekly medication adherence feedback reports on statin adherence.

DESIGN:

Three-month, three-arm randomized clinical trial (ClinicalTrials.gov identifier: NCT02480530).

PARTICIPANTS:

One hundred and twenty-six veterans with known coronary artery disease and poor adherence (medication possession ratio <80 %).

INTERVENTION:

Patients were randomized to one of three groups: (1) a control group (n = 36) that received a pill-monitoring device with no alarms or feedback; (2) an individual feedback group (n = 36) that received a daily alarm and a weekly medication adherence feedback report; and (3) a partner feedback group (n = 54) that received an alarm and a weekly feedback report that was shared with a friend, family member, or a peer. The intervention continued for 3 months, and participants were followed for an additional 3 months after the intervention period.

MAIN MEASURES:

Adherence as measured by pill bottle. Secondary outcomes included change in LDL (mg/dl), patient activation, and social support.

KEY RESULTS:

During the 3-month intervention period, medication adherence was higher in both feedback arms than in the control arm (individual feedback group 89 %, partner feedback group 86 %, control group 67 %; p < 0.001 and = 0.001). At 6 months, there was no difference in medication adherence between either of the feedback groups and the control (individual feedback 60 %, partner feedback 52 %, control group 54 %; p = 0.75 and 0.97).

CONCLUSIONS:

Daily alarms combined with individual or partner feedback reports improved statin medication adherence. While neither an individual feedback nor partner feedback strategy created a sustainable medication adherence habit, the intervention itself is relatively easy to implement and low cost.

KEYWORDS:

medication adherence; social force; social support; statins

PMID:
27612487
PMCID:
PMC5330995
DOI:
10.1007/s11606-016-3858-0
[Indexed for MEDLINE]
Free PMC Article

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