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Reminders via phone help medication adherence

Sunday December 2, 2012
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Patients prescribed a cholesterol-lowering medication were more likely to pick it up from the pharmacy if they received automated phone and mail reminders, according to a study.

In the study of 5,216 Kaiser Permanente Southern California patients, those who received an automated reminder were 1.6 times more likely to fill prescriptions for cholesterol-lowering statins than those who did not receive a reminder.

Informational and encouraging phone calls were automatically generated if a patient did not pick up his or her medication within one to two weeks of receiving a prescription at a doctorís appointment. One week after the telephone call, the researchers sent a reminder letter to patients who still had not picked up their prescription.

When systems for automated outreach exist, the expense of outreach is relatively small, the researchers noted. Expenses for both these prompts totaled $1.70 per study participant. After the intervention, the proportion of patients who picked up their prescriptions increased from 26% to 42%.

"Getting patients to take the well-proven medicines their physicians prescribe for them will ultimately reduce their risk of heart attacks and stroke," study author Stephen F. Derose, MD, of the Kaiser Permanente Southern California Department of Research & Evaluation, said in a news release. "This automated intervention is a good way to very efficiently reach a large number of people and improve their health outcomes."

Medication nonadherence occurs when a patient does not follow a clinically prescribed medication course, endangering his or her health and possibly necessitating more aggressive treatment or hospitalizations. In the United States each year, medication nonadherence contributes to about 125,000 deaths and coasts the healthcare system $290 billion, the researchers said, citing previous studies,

One in three patients prescribed a medication by their healthcare provider never pick it up from the pharmacy, and, among those who do, nearly three in four do not take prescription drugs in accordance with providersí orders, according to the news release.

Although this study examined medication adherence exclusively among patients at Kaiser Permanente Southern California receiving their first prescription for a statin drug, the low-cost method is likely to be viable for large populations, other chronic conditions and other medications, the researchers said. Based on the study results, Kaiser Permanente Southern California implemented a new regional outreach program in April 2012. The program has sent reminders to about 2,200 members each month.

"Given the prevalence of the problem, especially among patients with chronic conditions, minor improvements in medication adherence among groups of people should yield significantly better health outcomes for patients and savings for hospitals and health systems," Derose said.

The study appeared Nov. 26 on the website of the Archives of Internal Medicine. The study abstract is available at http://archinte.jamanetwork.com/article.aspx?articleid=1399850.


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