Patient and Partner Feedback Reports to Improve Statin Medication Adherence: A Randomized Control Trial

J Gen Intern Med. 2017 Mar;32(3):256-261. doi: 10.1007/s11606-016-3858-0. Epub 2016 Sep 9.


Background: Simple nudges such as reminders and feedback reports to either a patient or a partner may facilitate improved medication adherence.

Objective: To test the impact of a pill bottle used to monitor adherence, deliver a daily alarm, and generate weekly medication adherence feedback reports on statin adherence.

Design: Three-month, three-arm randomized clinical trial ( identifier: NCT02480530).

Participants: One hundred and twenty-six veterans with known coronary artery disease and poor adherence (medication possession ratio <80 %).

Intervention: Patients were randomized to one of three groups: (1) a control group (n = 36) that received a pill-monitoring device with no alarms or feedback; (2) an individual feedback group (n = 36) that received a daily alarm and a weekly medication adherence feedback report; and (3) a partner feedback group (n = 54) that received an alarm and a weekly feedback report that was shared with a friend, family member, or a peer. The intervention continued for 3 months, and participants were followed for an additional 3 months after the intervention period.

Main measures: Adherence as measured by pill bottle. Secondary outcomes included change in LDL (mg/dl), patient activation, and social support.

Key results: During the 3-month intervention period, medication adherence was higher in both feedback arms than in the control arm (individual feedback group 89 %, partner feedback group 86 %, control group 67 %; p < 0.001 and = 0.001). At 6 months, there was no difference in medication adherence between either of the feedback groups and the control (individual feedback 60 %, partner feedback 52 %, control group 54 %; p = 0.75 and 0.97).

Conclusions: Daily alarms combined with individual or partner feedback reports improved statin medication adherence. While neither an individual feedback nor partner feedback strategy created a sustainable medication adherence habit, the intervention itself is relatively easy to implement and low cost.

Keywords: medication adherence; social force; social support; statins.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Cholesterol, LDL / blood
  • Coronary Artery Disease / drug therapy
  • Drug Packaging
  • Feedback*
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Male
  • Medication Adherence / psychology
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Reminder Systems*
  • Social Support


  • Cholesterol, LDL
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors

Associated data