The use of technology to improve medication adherence in heart failure patients: a systematic review of randomised controlled trials

Cheng, Chloe; Donovan, Gemma; Al-Jawad, Naseer; Jalal, Zahraa

doi:10.1186/s40545-023-00582-9

Cited by 9 publications

(5 citation statements)

References 31 publications

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“…Adherence was similarly high in all cohorts, and in a range not commonly seen for other prescription medicines. Patients with heart failure show a wide variability in adherence, but rates > 85% are uncommon 15 , 16 . When further assessing outcomes in patients who received treatment through both Medicare PDP and the PAP, we found adherence and persistence would be underestimated if solely assessed using Medicare PDP claims.…”

Section: Discussionmentioning

confidence: 99%

Adherence and persistence to tafamidis treatment among Medicare beneficiaries in the presence of a patient assistance program

Chung,

Cantu,

Pankratova

et al. 2024

Sci Rep

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Tafamidis is the only disease-modifying therapy approved to treat patients in the United States with transthyretin amyloid cardiomyopathy (ATTR-CM), which most commonly affects patients aged ≥ 65 years. The manufacturer operates a patient assistance program (PAP) to support access to tafamidis. This study conducted Privacy Preserving Record Linking (PPRL) using Datavant tokens to match patients across Medicare prescription drug plan (PDP) and PAP databases to evaluate the impact of PAPs on treatment exposure classification, adherence, and persistence determined using Medicare PDP data alone. We found 35% of Medicare PDP patients received tafamidis through the PAP only; 14% through both Medicare PDP and the PAP, and 51% through Medicare PDP only. Adherence and persistence were comparable between these cohorts but underestimated among patients who received ≥ 2 prescriptions through Medicare PDP and ≥ 1 through the PAP when solely using Medicare data versus pooled Medicare and PAP data (modified Medication Possession Ratio: 84% [69% ≥ 80% adherent] vs. 96% [93%]; Proportion of Days Covered: 77% [66% ≥ 80% adherent] vs. 88% [88%]; mean days to discontinuation: 186 vs. 252; total discontinuation: 13% vs. 11%). Cross-database PPRL is a valuable method to build more complete treatment journeys and reduce the risk of exposure misclassification in real-world analyses.

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Section: Discussionmentioning

confidence: 99%

Adherence and persistence to tafamidis treatment among Medicare beneficiaries in the presence of a patient assistance program

Chung,

Cantu,

Pankratova

et al. 2024

Sci Rep

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“…This suggests that nonadherence is a driver of AHF events and that it can be modified by appropriate treatment. 77 A recent analysis that examined technological interventions to improve adherence showed only limited benefit, 78 suggesting that a more complex intervention focusing on patients through specific HF clinics may be needed to improve adherence.…”

Section: Epidemiology and Causementioning

confidence: 99%

Acute Heart Failure Is a Malignant Process: But We Can Induce Remission

Cotter,

Davison,

Lam

et al. 2023

JAHA

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Acute heart failure is a common and increasingly prevalent condition, affecting >10 million people annually. For those patients who survive to discharge, early readmissions and death rates are >30% everywhere on the planet, making it a malignant condition. Beyond these adverse outcomes, it represents one of the largest drivers of health care costs globally. Studies in the past 2 years have demonstrated that we can induce remissions in this malignant process if therapy is instituted rapidly, at the first acute heart failure episode, using full doses of all available effective medications. Multiple studies have demonstrated that this goal can be achieved safely and effectively. Now the urgent call is for all stakeholders, patients, physicians, payers, politicians, and the public at large to come together to address the gaps in implementation and enable health care providers to induce durable remissions in patients with acute heart failure.

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“…While this method has proven successful in enhancing medication adherence across various health conditions, its effectiveness in HF patients has not been sufficiently examined, and the results from previous studies have been inconsistent [ 22 , 23 ]. The notable characteristic of this research is its methodology, which incorporated the expertise of an information technology consultant to dispatch automated and personalized text message reminders to patients exactly at their designated medication intake times.…”

Section: Introductionmentioning

confidence: 99%

Randomized comparison of the effects of tailored text messaging versus pillbox organizers on medication adherence of heart failure patients

FarzanehRad,

Allahbakhshian,

Gholizadeh

et al. 2024

BMC Cardiovasc Disord

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Background Heart failure (HF) is a major public health issue worldwide, affecting approximately 64.3 million people in 2017. Non-adherence to medication is a common and serious issue in the management of HF. However, new reminder systems utilizing mobile technology, such as text messaging, have shown promise in improving medication adherence. The purpose of this study was to compare the impact of tailored text messaging (TTM) and pillbox organizers on medication adherence in individuals with HF. Methods A randomized controlled trial was conducted, involving 189 eligible patients with HF who were randomly assigned to either the TTM, pillbox organizer, or control group. Medication adherence was evaluated using pill counting and the Medication Adherence Rating Scale (MARS) over a period of three months and compared across the groups. The data were analyzed using Kruskal-Wallis, Analysis of Variance (ANOVA), and Repeated Measures ANOVA tests. Results The results indicate that both the TTM and pillbox organizers groups had significantly higher medication adherence compared to the control group, as measured by pill counting (MD = 0.05, 95%CI = 0.03–0.06; p < 0.001 for TTM group, MD = 0.04, 95%CI = 0.03–0.06; p < 0.001 for pillbox organizers group) and the MARS (MD = 1.32, 95%CI = 0.93 to 1.72; p < 0.001 for TTM group, MD = 1.33, 95%CI = 0.95 to 1.72; p < 0.001 for pillbox organizers group). However, there was no statistically significant difference in medication adherence between the two intervention groups using either measurement method. The TTM group exhibited a lower hospitalization rate than the other groups in the first follow up (p = 0.016). Conclusions Both the TTM and pillbox organizers were shown to be effective in enhancing medication adherence among patients with HF. Therefore, healthcare providers should take into account the patient’s condition and preferences when selecting one of these methods to promote medication adherence. Future research should aim to address the limitations of this study, such as controlling for confounding variables, considering long-term effects, and comparing the effectiveness of different interventions.

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The use of technology to improve medication adherence in heart failure patients: a systematic review of randomised controlled trials

Cited by 9 publications

References 31 publications

Adherence and persistence to tafamidis treatment among Medicare beneficiaries in the presence of a patient assistance program

Adherence and persistence to tafamidis treatment among Medicare beneficiaries in the presence of a patient assistance program

Acute Heart Failure Is a Malignant Process: But We Can Induce Remission

Randomized comparison of the effects of tailored text messaging versus pillbox organizers on medication adherence of heart failure patients

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