Partners and Alerts: A Study of Social Forces in Medication Adherence
| Status: | Completed |
|---|---|
| Conditions: | Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 11/18/2017 |
| Start Date: | June 2013 |
| End Date: | August 2017 |
The overall objectives of this study are to improve medication adherence of patients and
subsequent health outcomes.
This study is designed to examine the existence of strong associations between social
networks and health behavior. This study intends to demonstrate that social forces are
particularly effective at building enduring habits for healthy behavior, specifically
adherence to statin medication for this study. The investigators believe the improved
medication adherence will result in fewer additional vascular events, following the most
recent of these events, and will result in fewer patient hospitalizations. The investigators
will leverage insights from the fields of social comparison (being provided with information
about the actions of others prompts social comparison that can significantly influence
behavior), social pressures (encouragement or discouragement from others is a powerful social
force that can influence individual behavior), and social triggers (cues in the environment
can motivate people to take certain actions and have powerful effects on purchasing
behavior).
The results of this study and experience gained from the implementation of these
interventions will be used to inform new versions of a larger trial intervention to be tested
in new patient cohorts in a rapid cycle framework.
subsequent health outcomes.
This study is designed to examine the existence of strong associations between social
networks and health behavior. This study intends to demonstrate that social forces are
particularly effective at building enduring habits for healthy behavior, specifically
adherence to statin medication for this study. The investigators believe the improved
medication adherence will result in fewer additional vascular events, following the most
recent of these events, and will result in fewer patient hospitalizations. The investigators
will leverage insights from the fields of social comparison (being provided with information
about the actions of others prompts social comparison that can significantly influence
behavior), social pressures (encouragement or discouragement from others is a powerful social
force that can influence individual behavior), and social triggers (cues in the environment
can motivate people to take certain actions and have powerful effects on purchasing
behavior).
The results of this study and experience gained from the implementation of these
interventions will be used to inform new versions of a larger trial intervention to be tested
in new patient cohorts in a rapid cycle framework.
This study is a 4-arm pilot study involving 248 patients (62 per arm) who are on a once-a-day
statin who have a medication adherence ratio (MPR) that is less than 80%. Patients in all
arms would receive a GlowCap, manufactured by Vitality Inc., which records pill-bottle
openings and be asked to use the GlowCap for that medication for the duration of the study.
The study arms leverage two strategies that the investigators think will be particularly
effective at improving adherence and may be even more effective when used in tandem. Patients
in some arms will be asked to select an adherence partner: another person who can help them
adhere to their medication regimen. The investigators will contact this adherence partner and
ask them to officially accept this role and provide guidance of their choosing as to how they
can help the patient adhere. In addition, patients in some arms will receive an alert
whenever two full days pass without their GlowCap being opened (i.e. 48 hours of
non-adherence). This alert will encourage them to begin taking their medication again. The
design allows for some patients to have both an adherence partner and to receive alerts after
48 hours of non-adherence. In these arms, the adherence partner would also receive the alert
after 48 hours of non-adherence. This introduces a two-by-two design.
Subjects would spend 6 months in their randomly assigned treatment, and the investigators
will compare adherence of subjects in each of the arms to one another.
The investigators plan to track daily adherence of patients to a prescribed chronic disease
drug using a new technology that electronically monitors when a pill bottle has been opened.
In our control condition, patients will be monitored but not be provided with any reminders,
adherence information, or inclusion of friend of family member to help them adhere to their
medication. Our four additional treatments will either: (1) email the patient after 48 hours
of non-adherence; (2) allow the patient to select friend or family member to encourage
medication adherence; (3) email the patient, as well as patient-selected friends or family
members after 48 hours of non-adherence; or (4) provide the patient with a daily email, text
message, or phone call reminder to take the pill.
statin who have a medication adherence ratio (MPR) that is less than 80%. Patients in all
arms would receive a GlowCap, manufactured by Vitality Inc., which records pill-bottle
openings and be asked to use the GlowCap for that medication for the duration of the study.
The study arms leverage two strategies that the investigators think will be particularly
effective at improving adherence and may be even more effective when used in tandem. Patients
in some arms will be asked to select an adherence partner: another person who can help them
adhere to their medication regimen. The investigators will contact this adherence partner and
ask them to officially accept this role and provide guidance of their choosing as to how they
can help the patient adhere. In addition, patients in some arms will receive an alert
whenever two full days pass without their GlowCap being opened (i.e. 48 hours of
non-adherence). This alert will encourage them to begin taking their medication again. The
design allows for some patients to have both an adherence partner and to receive alerts after
48 hours of non-adherence. In these arms, the adherence partner would also receive the alert
after 48 hours of non-adherence. This introduces a two-by-two design.
Subjects would spend 6 months in their randomly assigned treatment, and the investigators
will compare adherence of subjects in each of the arms to one another.
The investigators plan to track daily adherence of patients to a prescribed chronic disease
drug using a new technology that electronically monitors when a pill bottle has been opened.
In our control condition, patients will be monitored but not be provided with any reminders,
adherence information, or inclusion of friend of family member to help them adhere to their
medication. Our four additional treatments will either: (1) email the patient after 48 hours
of non-adherence; (2) allow the patient to select friend or family member to encourage
medication adherence; (3) email the patient, as well as patient-selected friends or family
members after 48 hours of non-adherence; or (4) provide the patient with a daily email, text
message, or phone call reminder to take the pill.
Inclusion Criteria:
Patients must have
- experienced an AMI and have been placed on a once-a-day statin and have a medication
adherence ratio (MPR) that is less than 80%.
- access to internet to create an account on Way to Heath.
Exclusion Criteria:
- There are no exclusion criterial for patients able to provide consent and who meet the
eligibility criteria
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