Improving adherence to cardiovascular disease medications with information technology

William M. Vollmer, Ashil A. Owen-Smith, Jeffrey O. Tom, Reesa Laws, Diane G. Ditmer, David H. Smith, Amy C. Waterbury, Jennifer L. Schneider, Cyndee H. Yonehara, Andrew Williams, Suma Vupputuri, Cynthia S Rand

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: Evaluate the utility of 2 electronic medical record (EMR)-linked, automated phone reminder interventions for improving adherence to cardiovascular disease medications.

STUDY DESIGN: A 1-year, parallel arm, pragmatic clinical trial in which 21,752 adults were randomized to receive either usual care (UC) or 1 of 2 interventions in the form of interactive voice recognition calls-regular (IVR) or enhanced (IVR+). The interventions used automated phone reminders to increase adherence to cardiovascular disease medications. The primary outcome was medication adherence; blood pressure and lipid levels were secondary outcomes.

METHODS: The study took place in 3 large health maintenance organizations. We enrolled participants who were 40 years or older, had diabetes mellitus or atherosclerotic cardiovascular disease, and were suboptimally adherent. IVR participants received automated phone calls when they were due or overdue for a refill. IVR+ participants received these phone calls, plus personalized reminder letters, live outreach calls, EMR-based feedback to their primary care providers, and additional mailed materials.

RESULTS: Both interventions significantly increased adherence to statins and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) compared with UC (1.6 to 3.7 percentage points). Adherence to ACEIs/ARBs was also significantly higher for IVR+ relative to IVR participants. These differences persisted across subgroups. Among statin users, IVR+ participants had significantly lower low-density lipoprotein (LDL) levels at follow-up compared with UC (Δ = -1.5; 95% CI, -2.7 to -0.2 mg/dL); this effect was seen mainly in those with baseline LDL levels ≥ 100 mg/dL (Δ = -3.6; 95% CI, -5.9 to -1.3 mg/dL).

CONCLUSIONS: Technology-based tools, in conjunction with an EMR, can improve adherence to chronic disease medications and measured cardiovascular disease risk factors.

Original languageEnglish (US)
Pages (from-to)SP502-SP510
JournalAmerican Journal of Managed Care
Volume20
Issue number17
StatePublished - Nov 1 2014
Externally publishedYes

Fingerprint

Electronic Health Records
Cardiovascular Diseases
Technology
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Angiotensin Receptor Antagonists
LDL Lipoproteins
Angiotensin-Converting Enzyme Inhibitors
Pragmatic Clinical Trials
Medication Adherence
Health Maintenance Organizations
Primary Health Care
Diabetes Mellitus
Chronic Disease
Blood Pressure
Lipids

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Vollmer, W. M., Owen-Smith, A. A., Tom, J. O., Laws, R., Ditmer, D. G., Smith, D. H., ... Rand, C. S. (2014). Improving adherence to cardiovascular disease medications with information technology. American Journal of Managed Care, 20(17), SP502-SP510.

Improving adherence to cardiovascular disease medications with information technology. / Vollmer, William M.; Owen-Smith, Ashil A.; Tom, Jeffrey O.; Laws, Reesa; Ditmer, Diane G.; Smith, David H.; Waterbury, Amy C.; Schneider, Jennifer L.; Yonehara, Cyndee H.; Williams, Andrew; Vupputuri, Suma; Rand, Cynthia S.

In: American Journal of Managed Care, Vol. 20, No. 17, 01.11.2014, p. SP502-SP510.

Research output: Contribution to journalArticle

Vollmer, WM, Owen-Smith, AA, Tom, JO, Laws, R, Ditmer, DG, Smith, DH, Waterbury, AC, Schneider, JL, Yonehara, CH, Williams, A, Vupputuri, S & Rand, CS 2014, 'Improving adherence to cardiovascular disease medications with information technology', American Journal of Managed Care, vol. 20, no. 17, pp. SP502-SP510.
Vollmer WM, Owen-Smith AA, Tom JO, Laws R, Ditmer DG, Smith DH et al. Improving adherence to cardiovascular disease medications with information technology. American Journal of Managed Care. 2014 Nov 1;20(17):SP502-SP510.
Vollmer, William M. ; Owen-Smith, Ashil A. ; Tom, Jeffrey O. ; Laws, Reesa ; Ditmer, Diane G. ; Smith, David H. ; Waterbury, Amy C. ; Schneider, Jennifer L. ; Yonehara, Cyndee H. ; Williams, Andrew ; Vupputuri, Suma ; Rand, Cynthia S. / Improving adherence to cardiovascular disease medications with information technology. In: American Journal of Managed Care. 2014 ; Vol. 20, No. 17. pp. SP502-SP510.
@article{e5ca8674d8ab4a00ad23d03e53a80a59,
title = "Improving adherence to cardiovascular disease medications with information technology",
abstract = "OBJECTIVES: Evaluate the utility of 2 electronic medical record (EMR)-linked, automated phone reminder interventions for improving adherence to cardiovascular disease medications.STUDY DESIGN: A 1-year, parallel arm, pragmatic clinical trial in which 21,752 adults were randomized to receive either usual care (UC) or 1 of 2 interventions in the form of interactive voice recognition calls-regular (IVR) or enhanced (IVR+). The interventions used automated phone reminders to increase adherence to cardiovascular disease medications. The primary outcome was medication adherence; blood pressure and lipid levels were secondary outcomes.METHODS: The study took place in 3 large health maintenance organizations. We enrolled participants who were 40 years or older, had diabetes mellitus or atherosclerotic cardiovascular disease, and were suboptimally adherent. IVR participants received automated phone calls when they were due or overdue for a refill. IVR+ participants received these phone calls, plus personalized reminder letters, live outreach calls, EMR-based feedback to their primary care providers, and additional mailed materials.RESULTS: Both interventions significantly increased adherence to statins and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) compared with UC (1.6 to 3.7 percentage points). Adherence to ACEIs/ARBs was also significantly higher for IVR+ relative to IVR participants. These differences persisted across subgroups. Among statin users, IVR+ participants had significantly lower low-density lipoprotein (LDL) levels at follow-up compared with UC (Δ = -1.5; 95{\%} CI, -2.7 to -0.2 mg/dL); this effect was seen mainly in those with baseline LDL levels ≥ 100 mg/dL (Δ = -3.6; 95{\%} CI, -5.9 to -1.3 mg/dL).CONCLUSIONS: Technology-based tools, in conjunction with an EMR, can improve adherence to chronic disease medications and measured cardiovascular disease risk factors.",
author = "Vollmer, {William M.} and Owen-Smith, {Ashil A.} and Tom, {Jeffrey O.} and Reesa Laws and Ditmer, {Diane G.} and Smith, {David H.} and Waterbury, {Amy C.} and Schneider, {Jennifer L.} and Yonehara, {Cyndee H.} and Andrew Williams and Suma Vupputuri and Rand, {Cynthia S}",
year = "2014",
month = "11",
day = "1",
language = "English (US)",
volume = "20",
pages = "SP502--SP510",
journal = "American Journal of Managed Care",
issn = "1088-0224",
publisher = "Ascend Media",
number = "17",

}

TY - JOUR

T1 - Improving adherence to cardiovascular disease medications with information technology

AU - Vollmer, William M.

AU - Owen-Smith, Ashil A.

AU - Tom, Jeffrey O.

AU - Laws, Reesa

AU - Ditmer, Diane G.

AU - Smith, David H.

AU - Waterbury, Amy C.

AU - Schneider, Jennifer L.

AU - Yonehara, Cyndee H.

AU - Williams, Andrew

AU - Vupputuri, Suma

AU - Rand, Cynthia S

PY - 2014/11/1

Y1 - 2014/11/1

N2 - OBJECTIVES: Evaluate the utility of 2 electronic medical record (EMR)-linked, automated phone reminder interventions for improving adherence to cardiovascular disease medications.STUDY DESIGN: A 1-year, parallel arm, pragmatic clinical trial in which 21,752 adults were randomized to receive either usual care (UC) or 1 of 2 interventions in the form of interactive voice recognition calls-regular (IVR) or enhanced (IVR+). The interventions used automated phone reminders to increase adherence to cardiovascular disease medications. The primary outcome was medication adherence; blood pressure and lipid levels were secondary outcomes.METHODS: The study took place in 3 large health maintenance organizations. We enrolled participants who were 40 years or older, had diabetes mellitus or atherosclerotic cardiovascular disease, and were suboptimally adherent. IVR participants received automated phone calls when they were due or overdue for a refill. IVR+ participants received these phone calls, plus personalized reminder letters, live outreach calls, EMR-based feedback to their primary care providers, and additional mailed materials.RESULTS: Both interventions significantly increased adherence to statins and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) compared with UC (1.6 to 3.7 percentage points). Adherence to ACEIs/ARBs was also significantly higher for IVR+ relative to IVR participants. These differences persisted across subgroups. Among statin users, IVR+ participants had significantly lower low-density lipoprotein (LDL) levels at follow-up compared with UC (Δ = -1.5; 95% CI, -2.7 to -0.2 mg/dL); this effect was seen mainly in those with baseline LDL levels ≥ 100 mg/dL (Δ = -3.6; 95% CI, -5.9 to -1.3 mg/dL).CONCLUSIONS: Technology-based tools, in conjunction with an EMR, can improve adherence to chronic disease medications and measured cardiovascular disease risk factors.

AB - OBJECTIVES: Evaluate the utility of 2 electronic medical record (EMR)-linked, automated phone reminder interventions for improving adherence to cardiovascular disease medications.STUDY DESIGN: A 1-year, parallel arm, pragmatic clinical trial in which 21,752 adults were randomized to receive either usual care (UC) or 1 of 2 interventions in the form of interactive voice recognition calls-regular (IVR) or enhanced (IVR+). The interventions used automated phone reminders to increase adherence to cardiovascular disease medications. The primary outcome was medication adherence; blood pressure and lipid levels were secondary outcomes.METHODS: The study took place in 3 large health maintenance organizations. We enrolled participants who were 40 years or older, had diabetes mellitus or atherosclerotic cardiovascular disease, and were suboptimally adherent. IVR participants received automated phone calls when they were due or overdue for a refill. IVR+ participants received these phone calls, plus personalized reminder letters, live outreach calls, EMR-based feedback to their primary care providers, and additional mailed materials.RESULTS: Both interventions significantly increased adherence to statins and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) compared with UC (1.6 to 3.7 percentage points). Adherence to ACEIs/ARBs was also significantly higher for IVR+ relative to IVR participants. These differences persisted across subgroups. Among statin users, IVR+ participants had significantly lower low-density lipoprotein (LDL) levels at follow-up compared with UC (Δ = -1.5; 95% CI, -2.7 to -0.2 mg/dL); this effect was seen mainly in those with baseline LDL levels ≥ 100 mg/dL (Δ = -3.6; 95% CI, -5.9 to -1.3 mg/dL).CONCLUSIONS: Technology-based tools, in conjunction with an EMR, can improve adherence to chronic disease medications and measured cardiovascular disease risk factors.

UR - http://www.scopus.com/inward/record.url?scp=84946415662&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84946415662&partnerID=8YFLogxK

M3 - Article

C2 - 25811824

AN - SCOPUS:84946415662

VL - 20

SP - SP502-SP510

JO - American Journal of Managed Care

JF - American Journal of Managed Care

SN - 1088-0224

IS - 17

ER -