Title

Healthcare information technology interventions to improve cardiovascular and diabetes medication adherence

UMMS Affiliation

Meyers Primary Care Institute

Date

12-16-2010

Document Type

Article

Medical Subject Headings

Antihypertensive Agents; Cardiovascular Diseases; Diabetes Mellitus; Drug Utilization; Humans; Medical Informatics Applications; *Medication Adherence; Randomized Controlled Trials as Topic; Reminder Systems

Disciplines

Health Services Research | Medicine and Health Sciences

Abstract

OBJECTIVE: To determine the efficacy of healthcare information technology (HIT) interventions in improving adherence.

STUDY DESIGN: Systematic search of randomized controlled trials of HIT interventions to improve medication adherence in cardiovascular disease or diabetes.

METHODS: Interventions were classified as 1-way patient reminder systems, 2-way interactive systems, and systems to enhance patient-provider interaction. Studies were subclassified into those with and without real-time provider feedback. Cohen's d effect sizes were calculated to assess each intervention's magnitude of effectiveness.

RESULTS: We identified 7190 articles, only 13 of which met inclusion criteria. The majority of included studies (54%, 7 studies) showed a very small ES. The effect size was small in 15%, large in 8%, and was not amenable to calculation in the remainder. Reminder systems were consistently effective, showing the largest effect sizes in this review. Education/counseling HIT systems were less successful, as was the addition of realtime adherence feedback to healthcare providers. Interactive systems were rudimentary and not integrated into electronic health records; they exhibited very small effect sizes. Studies aiming to improve patient-provider communication also had very small effect sizes.

CONCLUSIONS: There is a paucity of data about HIT's efficacy in improving adherence to medications for cardiovascular disease and diabetes, although simple patient reminder systems appear effective. Future studies should focus on more sophisticated interactive interventions that expand the functionality and capabilities of HIT and better engage patients in care.

Rights and Permissions

Citation: Am J Manag Care. 2010 Dec;16(12 Suppl HIT):SP82-92. Link to article on publisher's website

Related Resources

Link to Article in PubMed

PubMed ID

21314228