Improving adherence to cardiovascular disease medications with information technology

Area of Science:

• Cardiovascular Medicine
• Health Informatics
• Behavioral Science

Background:

• Medication non-adherence is a significant barrier to managing chronic cardiovascular diseases.
• Electronic medical record (EMR)-linked interventions offer a promising avenue for improving patient adherence.

Purpose of the Study:

• To evaluate the effectiveness of two EMR-linked, automated phone reminder interventions in improving adherence to cardiovascular disease medications.
• To assess the impact of these interventions on blood pressure and lipid levels.

Main Methods:

• A 1-year pragmatic clinical trial randomized 21,752 adults with suboptimal adherence to cardiovascular medications to usual care (UC), regular interactive voice recognition (IVR) calls, or enhanced IVR (IVR+) with additional outreach.
• Participants were 40+ years old with diabetes or atherosclerotic cardiovascular disease, enrolled across three health maintenance organizations.

Main Results:

• Both IVR and IVR+ significantly increased adherence to statins and ACEIs/ARBs compared to UC (1.6–3.7 percentage points).
• IVR+ demonstrated superior adherence to ACEIs/ARBs compared to IVR.
• IVR+ significantly reduced LDL cholesterol levels in statin users, particularly those with baseline LDL ≥ 100 mg/dL.

Conclusions:

• EMR-integrated, technology-based tools like automated phone reminders are effective in enhancing medication adherence for chronic diseases.
• These interventions can positively impact key cardiovascular disease risk factors, such as lipid levels.