Tele-Pharmacy Intervention to Improve Treatment Adherence (STIC2IT)

Mass General Brigham

Status: Completed

Conditions: Hypertension; Diabetes; Hyperlipidemia

Treatments: Behavioral: Telepharmacist intervention

Study type: Interventional

Funder types: Other

Identifiers

NCT02512276

2013P001076

Details and patient eligibility

About

The purpose of this cluster randomized controlled trial is to evaluate whether a novel tele-pharmacist-based intervention for patients with hyperlipidemia, hypertension, and diabetes improves medication adherence, disease control, and patients' understanding of their treatment.

Full description

Long-term adherence to evidence-based medications remains exceptionally poor. Half of all patients become non-adherent within a year of treatment initiation. Interventions that improve medication adherence may have important clinical benefits across large populations, and may even be cost-saving by reducing rates of costly and morbid clinical outcomes such as myocardial infarction and stroke.

The Study of a Tele-pharmacy Intervention for Chronic diseases to Improve Treatment adherence (STIC 2 IT) is a cluster randomized controlled trial (RCT) evaluating whether a novel tele-pharmacist-based intervention improves medication adherence and disease control among individuals with hyperlipidemia, hypertension, and diabetes who are nonadherent to their medications and who have poor or worsening disease control. The intervention consists of a brief telephonic consultation with a clinical pharmacist using behavioral interviewing techniques tailored to patient's level of health activation and progress reports of medication-taking and disease control. Based on the barriers identified during the consultation, patients will be offered more intensive support including reminder and motivational text-messages, video visits and pillboxes. Potentially eligible patients will be identified using data from paid-prescription claims data and the electronic health record. The study is being conducted at 14 practice sites in a large multi-specialty group practice with approximately 250 primary care physicians. Practice sites will be randomized to intervention or control. In intervention sites, the primary care physicians of potentially eligible patients will be asked whether they would like patients to be enrolled in the intervention.

Enrollment: 4,078 patients

Sex: All

Ages: 18 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Filled and poorly adherent (defined as a PDC < 80%) to medication for hyperlipidemia, hypertension, or diabetes
• Suboptimal average adherence to all of the qualifying medications that a patient has filled (defined as combined (average of averages) PDC < 80%)
• For patients with hypertension or diabetes, poor or worsening disease control (according to relevant clinical targets)

Exclusion criteria

• Patients with <6 months of continuous enrolment in the health plan
• Patients with no available contact information

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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4,078 participants in 2 patient groups

Telepharmacist intervention

Experimental group

Description:

Patients diagnosed with diabetes, hypertension, or hyperlipidemia exhibiting sub-optimal adherence to their medications \[defined as combined (average of averages) proportion of days covered (PDC) \< 80%\] who also have poor or worsening disease control.

Treatment:

Behavioral: Telepharmacist intervention

Usual care

No Intervention group

Description:

Patients randomized to this arm will receive usual care.