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N/A N=21,752 Randomized Health Services Research

Promoting Adherence to Improve Effectiveness of Cardiovascular Disease Therapies

Diabetes Mellitus · Cardiovascular Disease

Enrolled (actual)
21,752
Serious AEs
0.3%
Results posted
Feb 2017
Primary outcome: Primary: Adherence to Statins — 0.55; 0.57; 0.58; 0.38 mMPR as a fraction — p=<.001

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
Interactive Voice Recognition (IVR) phone calls (Other); Educational mailings and follow-up for nonadherence (Other)
Age
Adult, Older Adult · 40+ yrs
Sex
All
Sponsor
Kaiser Permanente
Primary completion
Aug 2013

Outcome Measures

OutcomeResultp-value
PRIMARY
Adherence to Statins
0.55; 0.57; 0.58; 0.38; 0.41; 0.41 <.001 sig
PRIMARY
Adherence to Angiotensin-Converting Enzyme Inhibitors (ACEIs) and Angiotensin Receptor Blockers (ARBs)
0.57; 0.59; 0.61; 0.45; 0.47; 0.50 0.022 sig
SECONDARY
Percentage With Good (>80%) Statin Adherence
32.9; 35.9; 35.8; 21.5; 22.6; 21.8 0.002 sig
SECONDARY
Percentage With Good (>80%) ACEI/ARB Adherence
37.4; 40.3; 41.6; 24.5; 27.0; 28.2 0.014 sig
SECONDARY
Systolic Blood Pressure (SBP)
129.2; 128.6; 129.0; 123.5; 122.8; 123.4 .041 sig
SECONDARY
Percentage With Good (<140/90 mmHg) Blood Pressure Control
81.1; 82.1; 81.3; 93.7; 94.0; 92.9 .404
SECONDARY
Post Intervention Low Density Lipoprotein (LDL) Level
92.4; 91.8; 91.3; 75.5; 75.5; 75.6 .38
SECONDARY
Percentage With Good (<=100mg/dL) Low Density Lipoprotein (LDL) Control
69.1; 69.8; 70.4; 88.4; 88.0; 88.1 .59

Summary

The purpose of this randomized clinical trial is to determine whether two low-intensity, technology based interventions, when compared to each other and to usual care, improve adherence to selected medications that are used to treat people with cardiovascular disease (CVD) and diabetes.

Eligibility Criteria

Inclusion Criteria

  • Aged 40 years or older as of time of randomization.
  • Flagged in KP's databases as having either diabetes or atherosclerotic cardiovascular disease(defined as coronary artery disease, peripheral vascular disease, or a history of atherosclerotic stroke) at the time of randomization
  • At least one dispensing of an ACEI, ARB, or statin from a Kaiser Permanente (KP) outpatient pharmacy during the baseline year.
  • Suboptimal adherence ((MPR<0.9) to either statins or ACEI/ARBs during the baseline year
  • Continuous membership in KP for the 12 months prior to randomization.
  • Qualified for an intervention call at the time of randomization.

Exclusion Criteria

  • Evidence in the electronic medical record (EMR) of allergy or intolerance to statins or ACE inhibitors/ARBs
  • medical conditions that would contraindicate use of statins or ACEI/ARBs
  • Absence of either a phone number or mailing address in the EMR
  • for Kaiser Permanente Hawaii, clinics whose patients tend to fill prescriptions primarily at non-KP pharmacies
  • on Kaiser Permanente's "do not contact" list or in other research studies that could add undue burden
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT01251757). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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