Increasing the Detection and Response to Adherence Problems with Cardiovascular Medication in Primary Care through Computerized Drug Management Systems: A Randomized Controlled Trial

Robyn Tamblyn, Kristen Reidel, Allen Huang, Laurel Taylor, Nancy Winslade, Gillian Bartlett, Roland Grad, André Jacques, Martin Dawes, Pierre Larochelle and Alain Pinsonneault
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Robyn Tamblyn: Department of Epidemiology & Bio-statistics, McGill University
Kristen Reidel: Department of Epidemiology & Bio-statistics, McGill University
Allen Huang: Department of Medicine, McGill University
Laurel Taylor: Faculty of Management, McGill University
Nancy Winslade: Department of Medicine, McGill University
Gillian Bartlett: Department of Medicine, McGill University
Roland Grad: Department of Family Medicine, McGill University
André Jacques: College of Physicians of Quebec
Martin Dawes: Faculty of Management, McGill University
Pierre Larochelle: Department of Medicine, University of Montreal Montreal, Quebec, Canada
Alain Pinsonneault: Faculty of Management, McGill University

Medical Decision Making, 2010, vol. 30, issue 2, 176-188

Abstract: Background. Adherence with antihypertensive and lipid-lowering therapy is poor, resulting in an almost 2-fold increase in hospitalization. Treatment side effects, cost, and complexity are common reasons for nonadherence, and physicians are often unaware of these potentially modifiable problems. Objective. To determine if a cardiovascular medication tracking and nonadherence alert system, incorporated into a computerized health record system, would increase drug profile review by primary care physicians, increase the likelihood of therapy change, and improve adherence with antihypertensive and lipid-lowering drugs. Methods. There were 2293 primary care patients prescribed lipid-lowering or antihypertensive drugs who were randomized to the adherence tracking and alert system or active medication list alone to determine if the intervention increased drug profile review, changes in cardiovascular drug treatment, and refill adherence in the first 6 months. An intention to treat analysis was conducted using generalized estimating equations to account for clustering within physician. Results. Overall, medication adherence was below 80% for 36.3% of patients using lipid-lowering drugs and 40.8% of patients using antihypertensives at the start of the trial. There was a significant increase in drug profile review in the intervention compared to the control group (44.5% v. 35.5%; P

Keywords: medication adherence; computer decision support; cardiovascular; RCT. (search for similar items in EconPapers)
Date: 2010
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:30:y:2010:i:2:p:176-188

DOI: 10.1177/0272989X09342752

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