A randomized telephone intervention trial to reduce primary medication nonadherence.

Area of Science:

• Health Services Research
• Patient Adherence Studies
• Chronic Disease Management

Background:

• Primary medication nonadherence (PMN), the failure to obtain an initial prescription, compromises treatment efficacy for chronic conditions.
• Limited research exists on effective interventions to mitigate PMN.

Purpose of the Study:

• To assess if a nurse-led telephone intervention can reduce PMN in patients with persistent nonadherence after standard pharmacy outreach.
• To evaluate medication pickup rates following the intervention.

Main Methods:

• Patients with new prescriptions for asthma, hypertension, diabetes, or hyperlipidemia who did not pick them up after 3 pharmacy contacts were randomized.
• The intervention group received targeted telephone outreach from a nursing call center to address barriers and encourage prescription pickup.
• Medication pickup rates were compared between the intervention and control groups.

Main Results:

• The nurse-directed intervention did not significantly increase prescription pickup rates (25% intervention vs. 24% control).
• Initial PMN rates in the overall population were 6%, lower than previously reported.
• Multivariate analyses adjusting for patient and medication factors did not alter these findings.

Conclusions:

• Nurse-directed telephone outreach was ineffective in improving primary medication adherence for patients with persistent nonadherence.
• Re-engaging prescribing clinicians may be a necessary strategy to enhance adherence in this population.
• The observed low initial PMN rate warrants further investigation in future studies.