Effect of Reminders on Adherence

Study Overview
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Brief Summary
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The investigators seek to increase medication adherence of subjects. The investigators will send mailings to customers of an insurance company, asking them to predict or commit to a certain level of behavior. The investigators will measure whether this increases medication adherence.

Detailed Description
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The investigators seek to increase medication adherence of subjects. The investigators will send mailings to customers of an insurance company, asking them to predict or commit to a certain level of behavior. The investigators will measure whether this increases medication adherence. The investigators will send mailings to subjects once per month, and elicit responses via mail, phone, and web surveys.

Official Title
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Prediction and Pre-commitment Mailings for Medication Adherence

Conditions
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Diabetes, Hypertension

Intervention / Treatment
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* Behavioral: Prediction mailing
* Behavioral: Commitment mailing
* Behavioral: Reminder
* Behavioral: Anonymity
* Behavioral: Identification


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: customers of the investigators' insurance company partner Exclusion Criteria: none

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Usual care control<br>No intervention, just usual care from the insurance company | |
| Experimental: Reminder control<br>Send a reminder to subjects every month | Behavioral: Reminder<br>* Remind people to take their medicine<br>|
| Experimental: Anonymous prediction<br>Ask subjects to anonymously predict their upcoming medication adherence | Behavioral: Prediction mailing<br>* Ask people to predict their upcoming medication adherence<br>Behavioral: Reminder<br>* Remind people to take their medicine<br>Behavioral: Anonymity<br>* Keep patient predictions and commitment anonymous<br>|
| Experimental: Anonymous commitment<br>Ask subjects to anonymously commit to their upcoming medication adherence | Behavioral: Commitment mailing<br>* Ask people to commit to their upcoming medication adherence<br>Behavioral: Reminder<br>* Remind people to take their medicine<br>Behavioral: Anonymity<br>* Keep patient predictions and commitment anonymous<br>|
| Experimental: Identified prediction<br>Ask subjects to predict their upcoming medication adherence and report it | Behavioral: Prediction mailing<br>* Ask people to predict their upcoming medication adherence<br>Behavioral: Reminder<br>* Remind people to take their medicine<br>Behavioral: Identification<br>* Ask patients to report their predictions and commitments<br>|
| Experimental: Identified commitment<br>Ask subjects to commit to their upcoming medication adherence and report it | Behavioral: Commitment mailing<br>* Ask people to commit to their upcoming medication adherence<br>Behavioral: Reminder<br>* Remind people to take their medicine<br>Behavioral: Identification<br>* Ask patients to report their predictions and commitments<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Medication refills | frequency of refilling medication | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hemoglobin A1C |  | 6 months | 
| LDL cholesterol |  | 6 months |