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.

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...

Epidemiology of Vasopressin Use for Adults With Septic Shock

Jul. 12, 2016

Emily A. Vail, Hayley B. Gershengorn, May Hua, Allan J. Walkey, and Hannah Wunsch

Abstract [from journal]

Rationale: Vasopressin may be used to treat vasodilatory hypotension in septic shock, but it is not recommended by guidelines as a first- or second-line agent. Little is known about how often the drug is used currently in septic shock.

Objectives: We conducted this study to describe patterns of vasopressin use in a large cohort of U.S. adults with septic shock and to identify patient and hospital characteristics associated with vasopressin use.

Methods: This was a


Biologic therapy adherence, discontinuation, switching, and restarting among patients with psoriasis in the US Medicare population

Mar. 22, 2016

Jalpa Doshi, Junko Takeshita, Lionel Pinto, Penxiang Li, Xinyan Yu, Preethi Rao, Hema N. Viswanathan, Joel M. Gelfand

In the Journal of the American Academy of Dermatology, Jalpa Doshi and colleagues, including Penxiang Li and Preethi Rao, investigate real-world utilization patterns of biologic therapy in Medicare beneficiaries with psoriasis. Studies indicate low adherence to biologics among patients with psoriasis, yet little is known about the adherence level in the Medicare population. Using data from the Medicare Chronic Condition Data Warehouse Part A, B, and D files with 12-month follow-up after index prescription, Doshi and colleagues conducted a retrospective claims analysis on 2707...

Effect of Financial Incentives to Physicians, Patients, or Both on Lipid Levels: A Randomized Clinical Trial

Research Brief
Jan. 15, 2016

To whom should financial incentives be targeted to achieve a desired clinical or health outcome—physicians or patients? Using insight from behavioral economics, a research team led by LDI Senior Fellows David Asch and Kevin Volpp sought to determine whether physician financial incentives, patient incentives, or shared physician and patient incentives are more effective in promoting medication adherence and reducing cholesterol levels of patients at high risk for cardiovascular disease. Though physician and patient incentives are becoming more common, they are rarely combined, and effectiveness of these approaches is not well-established. This study offers insight into what incentive structure leads to the greatest impact on health promotion. 

Getting More Food-Allergic Young Adults To Carry Their Epinephrine: A Behavioral Economics Approach

Sep. 3, 2015

As one of the estimated 2.5% of Americans with a food allergy, deciding my next meal, snack, or even beverage is no simple task. Remembering to carry emergency epinephrine is also no walk in the park. Young adults like me are particularly vulnerable to error related to their food allergies and likely to engage in risky behavior. And despite the risk of death by anaphylaxis, few individuals with severe food allergies carry their emergency epinephrine on a daily basis.

Patient Perspectives of Acute Pain Management in the Era of the Opioid Epidemic

Apr. 9, 2015

Robert J. Smith, Karin Rhodes, Breah Paciotti, Sheila Kelly, Jeanmarie Perrone, Zachary F. Meisel

In the Annals of Emergency Medicine, Robert Smith and colleagues, including Karin Rhodes and Zachary Meisel, analyze patient perspectives on pain management, use of opioids, and understanding of the risks of developing opioid dependence. The authors conducted semi-structured telephone interviews with 23 patients recently discharged from an urban academic emergency department after presenting with acute back pain. Although patients discussed many topics, themes arose around: awareness of opioid dependence and addiction, and patient-provider communication around pain management. Patients...

Neighborhood Social Environment and Patterns of Adherence to Oral Hypoglycemic Agents Among Patients With Type 2 Diabetes Mellitus

Apr. 1, 2015

Heather F. de Vries, McClintock, Douglas J. Wiebe, Alison J. O'Donnell, Knashawn H. Morales, Dylan S. Small, Hillary R. Bogner

In Family and Community Health, Heather F. de Vries and colleagues, including Douglas Wiebe and Dylan Small, examine whether social environment is related to adherence to oral hypoglycemic agents among patients with type 2 diabetes mellitus. While individual characteristics are important contributors to medication adherence, much of the observed variation in adherence rates remains unexplained by these factors De Vries and colleagues compare residents in neighborhoods with high social affluence, high residential stability, and high neighborhood advantage to residents of...

Location of HIV Diagnosis Impacts Linkage to Medical Care

Mar. 1, 2015

Baligh R. Yehia, Elizabeth Ketner, Florence Momplaisir, Alisa J. Stephens-Shields, Nadia Dowshen, Michael G. Eberhart, Kathleen A. Brady

In the Journal of Acquired Immune Deficiency Syndromes, Baligh Yehia and colleagues investigate the importance of HIV diagnosis location for determining whether a person starts treatment in a timely manner. The U.S. National HIV/AIDS Strategy includes a goal to increase the proportion of persons linked to care within 3 months of diagnosis, which is critical to achieving HIV viral suppression. Baligh and colleagues analyze data on 1359 patients in Philadelphia newly diagnosed with HIV in 2010-2011. Diagnosis locations ranged from medical clinics and testing centers to inpatient settings and...