'Nudging' heart patients to take their statins leads to better adherence and better outcomes

November 14, 2019

Statins are an effective medication for treating patients with heart disease - they cut the risk of a second major adverse cardiac event by almost 50 percent. But only about six percent of patients take statins as prescribed. One way to solve that? Nudge them. Literally.

In a new study presented to heart specialists from around the world, researchers at the Intermountain Healthcare Heart Institute in Salt Lake City found that simple "nudges" in the form of texts, emails and phone calls, not only help patients fill that first statin prescription, but also continue to help them take their medications over the long term.

"These nudges are helping individuals increase and maintain their adherence to their medications more than the standard approach of giving a patient a prescription with little follow up," said Benjamin Horne, PhD, director of cardiovascular and genetic epidemiology at the Intermountain Healthcare Heart Institute. "Given what we know about statins improving long term outcomes for patients with heart disease, just reminding patients to take their medication can give them a much better chance of survival."

Findings from the study, which are part of the ENCOURAGE trial, a randomized clinical trial on the improvement of medication adherence through the implementation of personal nudges, will be presented at the 2019 American Heart Association Scientific Sessions in Philadelphia on Nov. 17.

For the study, researchers identified 186 adults from Intermountain Healthcare cardiovascular clinics who had a statin prescription and were also enrolled in Intermountain's SelectHealth insurance.

Patients were randomized so that half of them received nudges about their statin prescriptions (personalized in format and message per patient), and half received standard control care.

Nudges were personalized using machine learning techniques based on the patient's psychographic profile (e.g., their perspectives, impressions, and opinions about healthcare) and their health status and needs.

The analytic methods segmented patients into groups of individuals who had similar perspectives and needs. The content of each nudge, as well as the timing, frequency, and mode of contact, were precisely matched to the characteristics of each patient by study partner, CareCentra.

Researchers then tracked passively using medications claims data how often patients filled and refilled their prescriptions to determine their proportion of days covered by statins.

Researchers found that patients who received nudges were more likely to take their medications and had a higher percentage of the proportion of days covered (80%), meaning that they had better adherence to their prescribed statins.

They also found that patients in the control arm had gradual declines in proportion of days covered over the 12 months of the study, while those in the nudge group had a larger rate of adherence at the beginning of the study after their clinic visit.

"The group that received nudges then held those gains steady across the length of the study," said Dr. Horne.

These kinds of reminders are becoming more important in healthcare, said Dr. Horne, as less treatment is happening inside a healthcare setting, and as the popularity of technologies, such as wearables and smart watches, make these kinds of reminders possible.

"Nudges support and guide decisions made by the patients. We're not trying to take away any other options or stop them from making any specific decisions. It's just trying to make the right decision a little bit easier for the patient," added Dr. Horne.
Other members of the Intermountain research team: Joseph B. Muhlestein, Donald L. Lappe, Viet T. Le, Heidi T May, Tami L. Bair, Daniel Babcock, Daniel L. Bride, Kirk U. Knowlton, Jeffrey L. Anderson.

This research was funded by the Intermountain Research and Medical Foundation and an in-kind donation from study partner CareCentra.

Intermountain Medical Center

Related Heart Disease Articles from Brightsurf:

Cellular pathway of genetic heart disease similar to neurodegenerative disease
Research on a genetic heart disease has uncovered a new and unexpected mechanism for heart failure.

Mechanism linking gum disease to heart disease, other inflammatory conditions discovered
The link between periodontal (gum) disease and other inflammatory conditions such as heart disease and diabetes has long been established, but the mechanism behind that association has, until now, remained a mystery.

New 'atlas' of human heart cells first step toward precision treatments for heart disease
Scientists have for the first time documented all of the different cell types and genes expressed in the healthy human heart, in research published in the journal Nature.

With a heavy heart: How men and women develop heart disease differently
A new study by researchers from McGill University has uncovered that minerals causing aortic heart valve blockage in men and women are different, a discovery that could change how heart disease is diagnosed and treated.

Heart-healthy diets are naturally low in dietary cholesterol and can help to reduce the risk of heart disease and stroke
Eating a heart-healthy dietary pattern rich in vegetables, fruits, whole grains, low-fat dairy products, poultry, fish, legumes, vegetable oils and nuts, which is also limits salt, red and processed meats, refined-carbohydrates and added sugars, is relatively low in dietary cholesterol and supports healthy levels of artery-clogging LDL cholesterol.

Pacemakers can improve heart function in patients with chemotherapy-induced heart disease
Research has shown that treating chemotherapy-induced cardiomyopathy with commercially available cardiac resynchronization therapy (CRT) delivered through a surgically implanted defibrillator or pacemaker can significantly improve patient outcomes.

Arsenic in drinking water may change heart structure raising risk of heart disease
Drinking water that is contaminated with arsenic may lead to thickening of the heart's main pumping chamber in young adults, according to a new study by researchers at Columbia University Mailman School of Public Health.

New health calculator can help predict heart disease risk, estimate heart age
A new online health calculator can help people determine their risk of heart disease, as well as their heart age, accounting for sociodemographic factors such as ethnicity, sense of belonging and education, as well as health status and lifestyle behaviors.

Wide variation in rate of death between VA hospitals for patients with heart disease, heart failure
Death rates for veterans with ischemic heart disease and chronic heart failure varied widely across the Veterans Affairs (VA) health care system from 2010 to 2014, which could suggest differences in the quality of cardiovascular health care provided by VA medical centers.

Heart failure: The Alzheimer's disease of the heart?
Similar to how protein clumps build up in the brain in people with some neurodegenerative diseases such as Alzheimer's and Parkinson's diseases, protein clumps appear to accumulate in the diseased hearts of mice and people with heart failure, according to a team led by Johns Hopkins University researchers.

Read More: Heart Disease News and Heart Disease Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.