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Evaluation of a pilot intervention to support adherence to anti-hypertensive medications using interactive voice response, as an adjunct to primary care

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Abstract Background: non-adherence to anti-hypertensive (HBP) medication is a significant challenge to public health, and current practices show limited efficacy. Interactive Voice Response (IVR) interventions are effective at supporting adherence, but no such intervention has been developed and piloted. This submission describes the preliminary findings of the first IVR pilot intervention to support adherence to HBP medication. Methods: Eighteen patients with HBP, presumed to be non-adherent, were recruited opportunistically from three primary care practices. Patients completed a theory-based questionnaire at baseline (T1) and follow up (T2); and received highly tailored IVR messages daily, for 28 days. Medication adherence was measured using the Medication Adherence Rating Scale (MARS) at T1 and T2. Refill adherence data were obtained by the practice databases for a period of three months before T1 and at T2. The Medication Possession Ratio was used to calculate refill adherence. Descriptive statistics and t-test facilitated data analysis. Results: Patients reported better emotional state at T2 (mean=2.0, sd=.70) in comparison to T1 (mean=2.2, sd=.65); t(17)=2.04, p=.05. Patients had fewer days of refill non-adherence at T2 (Mean=7, SD=20.8) in comparison to T1 (Mean=14.7, SD=17), but that difference was not statistically significant; t(17)=1.19, p=.249. There was no effect in MARS. At T2, 82% of patients reported that the IVR was easy to use, 72% they would recommend it to other patients, and 77% were satisfied with the intervention. Discussion: IVR is a feasible intervention to support medication adherence, between primary care consultations. Future studies should investigate its effects further, using rigorous designs.



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School of Primary Care Showcase

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National Institute for Health Research (NIHR) (via University of Oxford) (293)