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• There are many barriers to medication adherence especially in members with chronic disease(s) such as diabetes, hypertension, and hyperlipidemia. Many different interventions have been used to improve medication adherence including educational strategies. Effects of educational strategies alone have produced inconsistent results, and multifaceted or multidisciplinary interventions are generally more effective.• A real-time fax intervention with prescribers of antidepressant medications for patients with delayed refills (more than 10 days) did not improve adherence; average antidepressant nonadherence rates among patients with delayed refills were approximately 75% (Baumbauer et al., 2006). The combination of monthly mailed personalized letters to patients nonadherent to antidepressants and lists of nonadherent patients sent to prescribers was associated with a small difference in adherence rates (MPR of 67% or more) at 90 days (66.9% intervention vs. 65.5% control, P < 0.001) and at 180 days (52.3% intervention vs. 50.2% control, P < 0.001; Hoffman et al., 2003).• Roumie et al. (2006) in a multifaceted intervention that included letters sent to patients combined with provider education (e-mail with Web-based link with hypertension treatment guidelines) and computerized alerts to providers found significantly better mean blood pressure after 6 months of follow-up compared with provider education alone or provider alerts plus provider education, and more patients in the combination intervention with patient letters attained systolic blood pressure control (140 millimeters mercury [mm Hg]), 60% versus 42% for provider education only and 41% for provider education plus alert (P = 0.012). ABSTRACT BACKGROUND: Medication nonadherence is a major concern for many health care stakeholders. Improving medication adherence in health plan members who have both hypertension and diabetes is essential for the successful management of these chronic diseases, with anticipated outcomes in decreased health care utilization, all-cause mortality and cost. What is already known about this subject

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