Incorporating Behavioral Science in Medication Adherence Communication: A Randomized Clinical Trial

Area of Science:

• Cardiovascular disease research
• Behavioral science applications in health
• Health services research

Background:

• Hypertension significantly elevates risks for myocardial infarction and strokes.
• Suboptimal adherence to antihypertensive medications is a major public health concern.
• Improving medication adherence can reduce hypertension-related morbidity and mortality.

Purpose of the Study:

• To evaluate the impact of mailed communications incorporating behavioral science principles on hypertension medication adherence.
• To assess the effectiveness of social norming, messenger effects, and processing fluency in mailed interventions.

Main Methods:

• A randomized clinical trial involving Medicare Advantage beneficiaries aged 65-80 years with hypertension.
• Participants received mailed communications with behavioral science principles or usual care (control).
• Hypertension medication adherence was measured using the proportion of days covered (PDC) from pharmacy claims.

Main Results:

• No significant difference in end-of-year medication adherence (PDC) was observed between intervention and control groups.
• The proportion of participants achieving an end-of-year PDC of 80% or greater did not differ significantly across groups.
• Mailed interventions utilizing social norms, messenger effects, and processing fluency showed no improvement in adherence.

Conclusions:

• Incorporating social norms, messenger effects, and processing fluency into mailed communications did not enhance hypertension medication adherence.
• Current behavioral science-based mailed interventions are insufficient for improving adherence in this population.
• Additional research is required to identify effective strategies for increasing medication adherence in patients with hypertension.