Medication Adherence

Whether and why patients take their medications as prescribed, for as long as prescribed, and the factors that encourage greater compliance with drug regimens.

Coercion or Caring: The Fundamental Paradox for Adherence Interventions for HIV+ People With Mental Illness

Jul. 3, 2017

Marlene M. Eisenberg, Michael Hennessy, Donna Coviello, Nancy Hanrahan, Michael B. Blank

In AIDS and Behavior, Marlene Eisenberg and colleagues, including Nancy Hanrahan and Michael Blank, examine if a high-intensity HIV-treatment intervention would be perceived as coercive by HIV-positive individuals with serious mental illness. Previous research has shown that potentially coercive mandates during the earliest stages of mental health treatment are associated with later treatment benefits. Furthermore, the prevalence of HIV is significantly higher among populations with mental illness. The authors developed an HIV management regimen that utilized advance practice...

Effect of Electronic Reminders, Financial Incentives, and Social Support on Outcomes After Myocardial Infarction

Jun. 30, 2017

Kevin G. Volpp, Andrea B. Troxel, Shivan J. Mehta, Laurie Norton, Jingsan Zhu, Raymond Lim, Wenli Wang, Noora Marcus, Christian Terwiesch, Kristen Caldarella, Tova Levin, Mike Relish, Nathan Negin, Aaron Smith-...

In JAMA Internal Medicine, Kevin Volpp and colleagues, including Shivan Mehta, Christian Terwiesch, Kristen Caldarella, and David Asch, investigate whether medication reminders, as well as financial and social support, delay re-hospitalization for a vascular event. The authors randomized participants to either a usual care group (the control), or to an intervention using electronic pill bottles, lottery incentives, and social support for medication adherence. The primary measured outcome of this study was time to first vascular-related re-hospitalization or death, but the authors...

Financial Incentives for Adherence to Hepatitis C Virus Clinical Care and Treatment: A Randomized Trial of Two Strategies

Jun. 29, 2017

David A. Wohl, Andrew G. Allmon, Donna Evon, Christopher Hurt, Sarah Ailleen Reifeis, Harsha Thirumurthy, Becky Straub, Angela Edwards, Katie R. Mollan

In Open Forum Infectious Diseases, David Wohl and colleagues, including Harsha Thirumurthy, assess the feasibility of two strategies for financially incentivizing adherence to Hepatitis C (HCV) care among patients with substance use disorders. Previous research has shown that, although rates of a sustained response to the virus (SVR) surpass 90%, patients experiencing substance use disorders may struggle to adhere to HCV care. The authors randomly assigned participants to either a fixed or lottery-based monetary incentive for attending clinic appointments, adhering to medications...

Development of a Patient-centered Outcome Measure for Emergency Department Asthma Patients

Jun. 21, 2017

Margaret E. Samuels-Kalow, Karin V. Rhodes, Mira Henien, Emily Hardy, Thomas Moore, Felicia Wong, Carlos A. Camargo Jr., Caroline T. Rizzo, Cynthia Mollen

In Academic Emergency Medicine, Margaret Samuels-Kalow and colleagues, including Karin Rhodes and Cynthia Mollen, explore patient-reported outcome measures for Emergency Department care among asthma patients.  As existing patient-reported outcome measures have limited applicability to emergency medicine, the authors seek to identify patient-centered concepts specific to emergent asthma care. They completed a three-phase qualitative study, in which adult asthma patients and parents of pediatric asthma patients identified important concepts for post-ED discharge success. These...

The Initiation of Chronic Opioids: A Survey of Chronic Pain Patients

Jun. 15, 2017

Catherine E. Callinan, Mark D. Neuman, Kim E. Lacy, Claudia Gabison, and Michael A. Ashburn

In The Journal of Pain, Catherine Callinan and colleagues, including Mark Neuman and Michael Ashburn, examine the connection between reasons for opioid initiation and risk factors for chronic usage. The investigators interviewed participants who received opioid therapy for more than 90 days, and who had a non-cancer pain diagnosis. They asked them about reason for opioid initiation, original intent of prescription, length of time on opioids, and demographic data including co-morbidities. Many patients who initiated opioid therapy after surgery experienced postoperative...

Young Transgender Women’s Attitudes Toward HIV Pre-exposure Prophylaxis

Jun. 12, 2017

Sarah M. Wood, Susan Lee, Frances K. Barg, Marne Castillo, Nadia Dowshen

In Journal of Adolescent Health, Sarah Wood and colleagues, including Nadia Dowshen, seek to understand young transgender women’s (YTW) attitudes toward HIV pre-exposure prophylaxis (PrEP) in order to improve PrEP uptake in this population. Previous studies have shown that, despite a significantly higher risk for HIV amongst YTW, awareness of and access to PrEP remains disproportionately low. The investigators conducted qualitative interviews focusing on participants’ knowledge, attitudes, and experience with PrEP. Sixty-four percent of participants reported knowledge of PrEP....

A randomized trial of lottery-based incentives and reminders to improve warfarin adherence: the Warfarin Incentives (WIN2) Trial

Nov. 20, 2016

Stephen E. Kimmel, Andrea B. Troxel, Benjamin French, George Loewenstein, Jalpa A. Doshi, Todd E. H. Hecht, Mitchell Laskin, Colleen M. Brensinger, Chris Meussner, Kevin Volpp

In Pharmacoepidemiology and Drug Safety, Stephen Kimmel and colleagues, including Jalpa Doshi, Benjamin French and Kevin Volpp, investigate the comparative effectiveness of reminders alone versus daily lottery incentives in improving medication adherence. This study was a four-arm multi-center...

Rationale and design of a randomized trial of automated hovering for post myocardial infarction patients: The HeartStrong program

Sep. 22, 2016

Andrea B. Troxel, David A. Asch, Shivan J. Mehta, Laurie Norton, Devon Taylor, Tirza A. Calderon, Raymond Lim, Jingsan Zhu, Daniel M. Kolansky, Brian M. Drachman, Kevin G. Volpp

In the American Heart Journal, Andrea Troxel and colleagues, including Kevin Volpp, David Asch and Shivan Mehta, discuss the rationale and design of the HeartStrong program, a randomized controlled trial aimed at increasing medication adherence among patients with coronary artery disease. This trial features three main innovations: first, it uses behavioral economics concepts such as intermittent feedback, regret aversion and the entertainment value of a daily lottery; second, it automates procedures using new technology such as wireless pill bottles and remote feedback; and third...

Participation Rates With Opt-out Enrollment in a Remote Monitoring Intervention for Patients With Myocardial Infarction

Sep. 13, 2016

Shivan J. Mehta, Andrea B. Troxel, Noora Marcus, Christina Jameson, Devon Taylor,  David A. Asch, and Kevin G. Volpp

In JAMA Cardiology, Shivan Mehta and colleagues, including Andrea Troxel, David Asch and Kevin Volpp, evaluate whether an opt-out approach to enrollment, which has been shown to be effective in behavioral economics research, increases participation in a remote monitoring intervention among patients with myocardial infarction. This prospective cohort study compared enrollment rates in a remote monitoring intervention for medication adherence, using an opt-in vs an opt-out approach. Opt-in participants were recruited in the 60 days after discharge by sending a recruitment letter to...

A Synchronized Prescription Refill Program Improved Medication Adherence

Aug. 5, 2016

Jalpa A. Doshi, Raymond Lim, Pengxiang Li, Peinie P. Young, Victor F. Lawnicki, Joseph J. State, Andrea B. Troxel, and Kevin G. Volpp

In Health Affairs, Jalpa Doshi and colleagues, including Pengxiang Lee, Andrea Troxel and Kevin Volpp, evaluate whether renewing all medications at the same time from the same pharmacy improves adherence to medication regimens. Synchronizing medication refills is an increasingly popular strategy, but there has been little research regarding its effectiveness. The authors looked at a pilot refill synchronization program implemented by Humana, a large national insurer, and analyzed patients’ adherence before and after participation in the program, compared to a control group. The...

Pages