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Automated but Personalized Reminders Improved Medication Adherence
Patient interactions potentially reduce managed care costs

By Stephen Miller  5/17/2010
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A 2010 study published in the journal Population Health Management finds that personalized health messages delivered through interactive technology can improve medication adherence to a cholesterol-reducing drug, or statin, that helps reduce the risk of heart attack. Improved compliance with prescribed drug therapy leads to reduced employer health care expenses through lowered managed care costs, the research suggests.

The study, published as Incorporating Tailored Interactive Patient Solutions Using Interactive Voice Response Technology to Improve Statin Adherence, was conducted by HealthMedia Inc., AstraZeneca and Humana. It found that people who received personalized reminders, even when delivered automatically, showed greater medication adherence vs. those who received a non-personalized intervention.

“Interactive technology based on behavioral science can easily and inexpensively reach large populations of health care consumers in diverse health care settings,” said Dr. Steve Schwartz, research director at HealthMedia Inc., a Johnson & Johnson company providing wellness and prevention services. “It’s an effective way to engage and motivate them to take an active role in improving their medication-taking behavior and managing their chronic conditions.”

Adherence to a medication is typically defined as the extent to which patients take medications as prescribed by a health care provider. The benefits of improved medication adherence include:

Fewer emergency room visits.

Lower absenteeism.

Higher productivity.

Decreased inpatient hospital stays.

Decreased morbidity and mortality.

Better controlled health care costs.

Non-adherence to medication regimens can result in an additional $100 billion in annual health care costs (see "Adherence to Medication," New England Journal of Medicine) and $50 billion in indirect productivity losses nationwide (see "Meta-Analysis of Trials of Interventions to Improve Medication Adherence," American Journal of Health-System Pharmacy). Statins are often prescribed for people with cardiovascular disease to lower the level of cholesterol in the blood and lower the risk of a heart attack.

Personalized Intervention

The study was designed as a real-world effectiveness trial to mimic the way the intervention would be implemented in a managed care organization. The study sought to determine if patients can benefit from personalized, interactive health messages delivered through interactive technology, including monitoring programs using text messaging and cell phone technology.

To maximize the validity of the findings, the personalized behavior intervention represented a mix of elements grounded in several behavioral theories. Subjects in the experimental group:

Received personalized behavioral support interactions delivered via an interactive voice response (IVR) system based on their cholesterol-related knowledge, attitudes, beliefs and perceived barriers to medication adherence.

Were mailed a tailored guide that reinforced similar themes.

They were reminded to refill their prescriptions on a timely basis, received positive reinforcement including tips for overcoming barriers and avoiding habit formation, and were encouraged to follow up with their doctor.

The control group received behavioral advice from one IVR call that was not personalized, coupled with an untailored self-help cholesterol management guide received through the mail.

Stephen Miller is an online editor/manager for SHRM.

Related Articles:

Individuals' Behavior Costs Billions Annually in Pharmacy Costs, SHRM Online Benefits Discipline, April 2010

Splitting Pills Can Cut Costs, But Only When Appropriate, SHRM Online Benefits Discipline, April 2010

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