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Healthcare information technology interventions to improve cardiovascular and diabetes medication adherence
Meyers Primary Care Institute Publications and Presentations
  • Alexander S. Misono, Brigham and Women’s Hospital
  • Sarah L. Cutrona, University of Massachusetts Medical School
  • Niteesh K. Choudhry, Harvard Medical School
  • Michael A. Fischer, Harvard Medical School
  • Margaret R. Stedman, Brigham and Women’s Hospital
  • Joshua N. Liberman, Geisinger Health System
  • Troyen Brennan, CVS Caremark
  • Sachin H. Jain, Department of Health and Human Services
  • William H. Shrank, Harvard Medical School
UMMS Affiliation
Meyers Primary Care Institute
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Document Type
Antihypertensive Agents; Cardiovascular Diseases; Diabetes Mellitus; Drug Utilization; Humans; Medical Informatics Applications; *Medication Adherence; Randomized Controlled Trials as Topic; Reminder Systems

OBJECTIVE: To determine the efficacy of healthcare information technology (HIT) interventions in improving adherence.

STUDY DESIGN: Systematic search of randomized controlled trials of HIT interventions to improve medication adherence in cardiovascular disease or diabetes.

METHODS: Interventions were classified as 1-way patient reminder systems, 2-way interactive systems, and systems to enhance patient-provider interaction. Studies were subclassified into those with and without real-time provider feedback. Cohen's d effect sizes were calculated to assess each intervention's magnitude of effectiveness.

RESULTS: We identified 7190 articles, only 13 of which met inclusion criteria. The majority of included studies (54%, 7 studies) showed a very small ES. The effect size was small in 15%, large in 8%, and was not amenable to calculation in the remainder. Reminder systems were consistently effective, showing the largest effect sizes in this review. Education/counseling HIT systems were less successful, as was the addition of realtime adherence feedback to healthcare providers. Interactive systems were rudimentary and not integrated into electronic health records; they exhibited very small effect sizes. Studies aiming to improve patient-provider communication also had very small effect sizes.

CONCLUSIONS: There is a paucity of data about HIT's efficacy in improving adherence to medications for cardiovascular disease and diabetes, although simple patient reminder systems appear effective. Future studies should focus on more sophisticated interactive interventions that expand the functionality and capabilities of HIT and better engage patients in care.

Am J Manag Care. 2010 Dec;16(12 Suppl HIT):SP82-92. Link to article on publisher's website
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Link to Article in PubMed
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Citation Information
Alexander S. Misono, Sarah L. Cutrona, Niteesh K. Choudhry, Michael A. Fischer, et al.. "Healthcare information technology interventions to improve cardiovascular and diabetes medication adherence" Vol. 16 Iss. 12 Suppl HIT (2010) ISSN: 1088-0224 (Linking)
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