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Decision support for evidence-based pharmacotherapy detects adherence problems but does not impact medication use
Janese M Willis1, Rex Edwards, Kevin J Anstrom
1Duke University Medical Center, Durham, NC, USA.
Studies in Health Technology and Informatics
|February 8, 2013
Summary
Clinical decision support (CDS) interventions did not improve patient medication adherence or outcomes. While CDS identified adherence issues and prompted care manager responses, it failed to change patient behavior regarding prescribed medications.
Area of Science:
- Health Services Research
- Clinical Informatics
- Patient Adherence Studies
Background:
- Medication non-adherence affects 30-50% of patients, impacting treatment efficacy and healthcare costs.
- Evidence-based pharmacotherapies are crucial, yet patient adherence remains a significant challenge in clinical practice.
Purpose of the Study:
- To evaluate the effectiveness of two clinical decision support (CDS) interventions on patient medication adherence.
- To assess the impact of CDS interventions on patient clinical and economic outcomes.
Main Methods:
- A randomized trial involving 2219 patients was conducted.
- Interventions included patient adherence reports to providers and reports plus email notices to care managers, compared to a control group.
- Outcomes were measured at an 18-month follow-up.
Main Results:
- No significant differences in patient medication adherence were observed between the intervention and control groups.
- No treatment-related differences in patient clinical or economic outcomes were found.
- CDS interventions successfully identified adherence deficits and increased care manager responses but did not alter patient behavior.
Conclusions:
- Clinical decision support interventions, despite successful delivery and identification of adherence issues, were ineffective in improving patient medication adherence.
- Current CDS strategies may not be sufficient to modify patient medication-taking behaviors.
- Further research is needed to develop more effective interventions to enhance medication adherence.
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