Effectiveness of mailed letters to improve medication adherence among Medicare Advantage Plan participants with chronic conditions.

Autor:	Mann A; Cigna-HealthSpring, Houston, TX, USA., Esse TW; CareAllies, Houston, TX, USA., Serna O; CareAllies, Houston, TX, USA., Castel LD; Cigna Health and Life Insurance Company, Raleigh, NC, USA, liana.castel@cigna.com.; Lundy-Fetterman School of Business, Campbell University, Buies Creek, NC, USA, liana.castel@cigna.com., Abughosh SM; Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, Houston, TX, USA.
Jazyk:	angličtina
Zdroj:	Patient preference and adherence [Patient Prefer Adherence] 2018 Dec 20; Vol. 13, pp. 37-46. Date of Electronic Publication: 2018 Dec 20 (Print Publication: 2019).
DOI:	10.2147/PPA.S185848
Abstrakt:	Background: Medication adherence is associated with improved health outcomes in multiple chronic diseases. Information is needed on the effectiveness of specific adherence interventions. This study's objectives were to quantify effects of a targeted mailing intervention on adherence among older adults at risk for nonadherence, and to examine associations of individual and plan characteristics with adherence. Materials and Methods: Among adults enrolled in a Medicare Advantage Plan with prescription drug coverage from May 2014 to June 2015, those identified as eligible for the mailing intervention had a late refill for oral antidiabetic medication, statin, angiotensin-converting enzyme inhibitor, or angiotensin receptor blocker medication and were previously unreachable by telephone. Pharmacy claims data were analyzed with the outcome of 6-month proportion of days covered (PDC) before and after the mailing. The t -test and chi-square analyses were used to evaluate univariate associations. Multivariable linear and logistic regression models were conducted to assess relative covariate effects. A sub-analysis of those with at least one medication fill post-mailing was also performed. Results: A total of 460 non-adherent individuals aged 70±10.5 years, with 50.2% female and 66.7% white individuals, were included. Of those who were mailed a letter, 24.1% became adherent to the specified maintenance medication. Those who received >30-day supplies were more than twice as likely to become adherent after the mailed letter than those who received 30-day supplies or less ( P <0.05). Baseline higher PDC was also associated with greater adherence post-mailing ( P <0.01). A total of 284 (61.7%) individuals filled their medication at least once after the mailed letter; of those, 39.1% became adherent (mean [SD] change in PDC =0.15 [±0.28]). Conclusion: Our findings suggest that a single mailed letter improved medication adherence by 24.1% in adults with chronic conditions. As a health plan seeking to improve its customers' well-being and outcomes, Cigna continues to utilize targeted mail interventions to improve medication adherence. Competing Interests: Disclosure At the time the work was conducted, Mann, Esse, Castel, and Serna were all full-time employees of Cigna Corporation or its operating subsidiaries. The authors report no other conflicts of interest in this work.
Databáze:	MEDLINE
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