Synchronization to Improve Non-Adherence to Cardiovascular Medications

Study Overview
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Brief Summary
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The aim of this study is to evaluate if synchronizing when patients with diabetes and/or coronary artery disease fill their prescriptions improves long-term adherence to these medications.

Official Title
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Synchronization to Improve Non-Adherence to Cardiovascular Medications (SyNCMed)

Conditions
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Chronic Disease, Cardiovascular Disease, Diabetes Mellitus

Intervention / Treatment
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* Behavioral: Prescription synchronization


Participation Criteria
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Eligibility Criteria
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We will enroll patients 18 years of age and older who within 6 months of study enrollment have filled ≥ 2 medications intended for long-term use (i.e. maintenance medications) by mail order at CVS Caremark. At least 1 of these 2 medications of must be for the treatment of diabetes or cardiovascular disease. In addition, these medications must be delivered on two or more unique delivery dates, there must be at least one refill remaining for all eligible medications and either all or none of their prescriptions must be enrolled in the ReadyFill@Mail program (see Intervention Description for details).

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: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Prescription synchronization<br> | Behavioral: Prescription synchronization<br>* Each patient's medication that has the greatest quantity of pills on hand after randomization will be defined as the index medication and partial supplies will be provided for all other eligible medications in order to synchronize all of a patient's medication. Prescribers will be contacted for a new prescription to ensure all eligible medications are on the same renewal schedule. Randomization will occur within strata of whether patients are enrolled in the ReadyFill@Mail program. Once synchronized, patients who are not enrolled in the ReadyFill@Mail program will initiate their own refills. Patients who are enrolled in the ReadyFill@Mail program will have their refills automatically filled, however patients may disenroll from ReadyFill@Mail at any time, in which case they will initiate their own refills. Patients may disenroll in whole or in part from the program at any point.<br>|
| No Intervention: Control<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Medication adherence | Average adherence to medications for the treatment of cardiovascular disease and diabetes medications as assessed using administrative pharmacy claims | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Full adherence to medications for the treatment of diabetes or cardiovascular disease | Percent of subjects achieving full adherence (defined as a Medication Possession Ratio > 80%) to medications for cardiovascular disease and diabetes | 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Prescription synchronization, Cardiovascular disease, Medication adherence, Randomized controlled trial, Chronic disease, Pharmacy benefit design, Quality improvement