HIT interventions promising tools in fight to improve medication adherence, despite paucity of data

A new study that reviews more than four decades of medical journal articles about the impact of health information technology (HIT) and electronic communications on medication adherence concludes that while there is evidence to suggest that simple electronic reminders are an effective and low-cost means to improve adherence, there are few studies that show how HIT can be leveraged to more thoughtfully engage or motivate patients to take medications as prescribed.

The study was published this week in the American Journal of Managed Care and is the result of a research partnership between Harvard University, Brigham and Women's Hospital and CVS Caremark – a three-year collaboration focused on developing a better understanding of patient behavior, particularly around medication adherence.

According to the researchers, the study findings "highlight the disappointing state of evidence on a topic of substantial health importance." The researchers concluded that as the U.S. "invests substantially in the broad implementation of HIT, innovative adherence interventions built on the capabilities of HIT are essential and must be rigorously tested to identify applicable best practices."

Researchers reviewed more than 7,000 articles published between 1966 and 2010 that discussed the use of HIT for treating cardiovascular disease and diabetes. After screening out articles that did not address how electronic communications can promote adherence, only 13 articles warranted full review.

"Despite the paucity of data, this review suggests that HIT interventions are promising tools in the fight to improve medication adherence," said William H. Shrank, MD, MSHS, of Brigham and Women's Hospital and Harvard, and the senior author of the studies. "While there have been many studies on the subject of boosting adherence, we were surprised to find so few on the topic of using health information technology to accomplish this goal."

"These findings show that our industry has a lot to learn in order to determine how we can most effectively use electronic communications to improve patient adherence," said Troyen A. Brennan, MD, MPH, executive vice president and chief medical officer of CVS Caremark, and an author.  "As HIT-based interventions are developed and enhanced, we need to focus on how the interventions will help improve patient behavior related to taking their medications and reduce medical costs in order to justify growing technology expenditures."

Improving adherence is important because keeping patients on prescriptions as directed by their physician, stabilizes health outcomes and is a cost-effective way to avoid unnecessary doctors' visits or hospitalizations. Non-adherence to medication costs the health care system up to $290 billion a year because many of the hospitalizations can be avoided if people take their medications as prescribed.