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Phone, postal reminders increase drug adherence, study shows

World News | December 11, 2012


Lynne Taylor

Phone, postal reminders increase drug adherence, study shows

Patients who were newly-prescribed a cholesterol-lowering drug were more likely to pick it up from the pharmacy if they received automated telephone and mail reminders, a new US study has found.

People who received an automated reminder were 1.6 times more likely to fill prescriptions for statins than those who did not receive a reminder, says the study, which was conducted by healthcare provider Kaiser Permanente and has been published in the Archives of Internal Medicine.

For the study, informational and encouraging phone calls were generated automatically if a patient did not collect their medication within one or two weeks of a doctor's appointment where a prescription was ordered. One week after the phone call, researchers sent a reminder letter to patients who still had not picked up their prescription. 

Where systems for automated outreach exist, their costs are relatively small, with expenses for both these prompts totalling $1.70 per participant in the study, the researchers note. After the intervention, the percentage of patients who collected their prescriptions increased from 26% to 42%, they add.

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

Previous research has suggested that medication non-adherence contributes to around 125,000 deaths in the US every year and costs the health system $290 billion. One in three patients who are prescribed a medication never pick it up from the pharmacy and, among those who do, nearly three in four US patients do not take prescription drugs according to instructions.

The study examined drug adherence only among patients at Kaiser Permanente Southern California receiving their first prescription for a statin, but the company says that this low-cost method is also likely to be viable for large populations, other chronic conditions and other medications. Based on the study's results, the firm has implemented a new regional outreach programme in South California, sending reminders to about 2,200 members every month.

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

Kaiser Permanente notes that it has the largest private electronic health system in the world, connecting nine million people, 533 medical offices and 37 hospitals. Previous research studies conducted by the firm have shown that patients whose pharmacies are linked to their electronic health records are more likely to pick up their prescriptions, that people who obtained new statin prescription via a mail-order pharmacy achieved better cholesterol control during their first year of therapy, and that purchasing mail-order medications may encourage patents to adhere to their prescribed medication regimen.

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