STUDY ON THE EFFECT OF COMBINED USE OF A REMOTE MONITORING PILLBOX, MULTI-DOSE BLISTER PACKAGING, AND AUTOMATED REMINDERS ON MEDICATION ADHERENCE IN PATIENTS ON LIPID LOWERING, ANTIHYPERTENSIVE, OR ORAL DIABETES THERAPIES

Author(s)

Gooneratne N¹, Smith-McLallen A², Brooks R², Valilis N³, Jain R³, Cerciello E³
¹University of Pennsylvania, Philadelphia, PA, USA, ²Independence Blue Cross, Philadelphia, PA, USA, ³TowerView Health, Philadelphia, PA, USA

OBJECTIVES: To assess the efficacy of a multi-modal, remote monitoring intervention on medication adherence of patients previously nonadherent to therapy (proportion of days covered (PDC) <80%) according to Independence Blue Cross claims data. METHODS: Patients with ongoing care at Penn Medicine, taking 4+ chronic oral medications, and established nonadherence to lipid lowering, antihypertensive, or oral diabetes therapies were invited to participate in the randomized controlled trial. Consenting patients were randomized to treatment or control arms and observed for 6 months. Patients in the treatment group received a commercially available service that includes 1) aligning the patient’s medication regimen into weekly multi-dose blister packages that insert into 2) a remote monitoring pillbox that alerts the patient with lights, sounds, phone, or text message reminders when a dose is missed and 3) relays adherence information to study staff for outreach if <80% of doses are taken for three consecutive days. Patients in the control group received usual care without reminders or outreach. RESULTS: Treatment (N=17) and control (N=33) groups were well-matched for demographics and adherence prior to randomization. In the 12 months prior to index date, the treatment group had an average PDC of 70.4% vs. 69.5% for the control group. All patients in the treatment group moved from non-adherent (PDC<80%) in the prior period to adherent in the treatment period across all drug classes of interest with number of on-time refills moving to 98%. At 6 months, treatment patients had higher rates of therapy persistence at 91.3% remaining persistent at 6 months vs 61.8% for control (Log-rank p<0.05). Potential covariates age, gender, education level, and race were not statistically significant in predicting early therapy termination. CONCLUSIONS: Patients on the intervention demonstrated significant and sustained improvements in medication adherence. Further testing should be done to determine the effectiveness of the approach on clinical outcomes and cost related measures.

Conference/Value in Health Info

2017-05, ISPOR 2017, Boston, MA, USA

Value in Health, Vol. 20, No. 5 (May 2017)

Code

PMD103

Topic

Clinical Outcomes

Topic Subcategory

Comparative Effectiveness or Efficacy, Relating Intermediate to Long-term Outcomes

Disease

Cardiovascular Disorders, Diabetes/Endocrine/Metabolic Disorders, Multiple Diseases

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