A remotely delivered multicomponent intervention behaviorally tailored to each patient improved medication adherence, but not clinical outcomes, results of the STIC2IT trial suggested.
The study, published in Annals of Internal Medicine, looked at 4,078 adults with poorly controlled disease (hyperlipidemia, hypertension and diabetes) who were also nonadherent to medication. Patients received either a tailored intervention that included telephone-delivered behavioral interviewing by pharmacists, pill boxes, text messages and progress reports, or usual care. Seven of the study’s 14 sites were randomized to the intervention. The primary study outcome was medication adherence via pharmacy claims data.
"A remotely delivered multicomponent behaviorally tailored intervention resulted in a statistically significant increase in medication adherence but did not change clinical outcomes." Another negative trial for remote interventions and medication adherence https://t.co/JXwtGFpLl7 pic.twitter.com/9W8ysDkFYS
— Anupam Goel (@anupam1623) August 8, 2018
According to the results, the tailored intervention was associated with a 4.7% (95% CI, 3.0%-6.4%) improvement in medication adherence compared to usual care. There were no differences in the odds of achieving adequate disease control, however, for at least one or all of the patient conditions. Patients receiving the intervention were less likely to have an emergency department visit. An as-treated analysis showed that the tailored intervention was associated with a 10.4% adherence increase.
A multicomponent, technologically enabled pharmacist intervention tailored to patients’ adherence barriers and level of health activation improved medication adherence for patients with common, chronic conditions but did not change clinical outcomes,” the researchers wrote. “Future work should focus on identifying which groups derive the most clinical benefit from adherence to improvement efforts.”
Remote pharmacist interventions aid #chronicillness management, #prevent hospitalization. @FZanjani , reminds me of your project.
Approach to Enhance Medication Taking for Patients With Hyperlipidemia, Hypertension, and Diabetes https://t.co/QD7FDvsJ86
— Cee A. Davis,MD,MPH (@cdBRComHealth) August 7, 2018
A remotely delivered multicomponent behaviorally tailored intervention resulted in a statistically significant increase in medication adherence but did not change clinical outcomes https://t.co/hPmOgKXRUL
— rodolfo catanho (@rocatanho) August 7, 2018
Chronic disease management is hard. This multicomponent, tech enabled pharmacist and behavioral intervention modestly improved medication adherence but not clinical outcomes https://t.co/4sVqnNqDdg
— Joseph Ross (@jsross119) August 7, 2018
4.7% ⬆️ in #adherence vs usual care but no diff in the odds of achieving good dz control for at least 1 or all eligible conditions,hospitalization, or having a physician office visit
Intervention participants were signif < likely to have an ED visit https://t.co/So07Jkc4lS
— John P Erwin III MD✭ (@HeartOTXHeartMD) August 6, 2018
Approach to Enhance Medication Taking for Patients With Hyperlipidemia, Hypertension, and Diabetes https://t.co/A5VCW5TmX4 Good intervention with a minimal result.
— Mark Harmel MPH, CDE (@MarkHarmel) August 7, 2018
Source: JAMA Internal Medicine