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

被引:37
作者
Reddy, Ashok [1 ,2 ,3 ]
Huseman, Tiffany L. [4 ]
Canamucio, Anne [4 ]
Marcus, Steven C. [5 ]
Asch, David A. [4 ,6 ,7 ]
Volpp, Kevin [4 ,6 ,7 ]
Long, Judith A. [4 ,6 ,7 ]
机构
[1] Univ Washington, Sch Med, Div Gen Internal Med, 1959 NE Pacific St,Suite BB1240,Box 356526, Seattle, WA 98195 USA
[2] UW Med Ctr Scholarship Patient Care Qual & Safety, Seattle, WA USA
[3] Univ Washington, Sch Med, Dept Med, 1959 NE Pacific St,Suite BB1240,Box 356526, Seattle, WA 98195 USA
[4] Philadelphia VA Med Ctr, VISN Ctr Evaluat PACT 4, Philadelphia, PA USA
[5] Univ Penn, Sch Social Policy & Practice, Philadelphia, PA 19104 USA
[6] Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA
[7] Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA
关键词
medication adherence; social force; social support; statins; MYOCARDIAL-INFARCTION; FINANCIAL INCENTIVES; THERAPY; MORTALITY; HEALTH;
D O I
10.1007/s11606-016-3858-0
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Simple nudges such as reminders and feedback reports to either a patient or a partner may facilitate improved medication adherence. 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. Three-month, three-arm randomized clinical trial (ClinicalTrials.gov identifier: NCT02480530). One hundred and twenty-six veterans with known coronary artery disease and poor adherence (medication possession ratio < 80 %). 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. Adherence as measured by pill bottle. Secondary outcomes included change in LDL (mg/dl), patient activation, and social support. 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). 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.
引用
收藏
页码:256 / 261
页数:6
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