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 (ClinicalTrials.gov 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.