Interventions to Improve Specialty Medication Adherence
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ClinicalTrials.gov Identifier: NCT03709277 |
Recruitment Status :
Completed
First Posted : October 17, 2018
Results First Posted : December 1, 2023
Last Update Posted : December 1, 2023
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Condition or disease | Intervention/treatment | Phase |
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Adherence, Medication Nonadherence, Medication | Behavioral: Pharmacist-Driven Intervention | Not Applicable |
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 438 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Supportive Care |
Official Title: | Patient-tailored Interventions to Improve Specialty Medication Adherence: Results From a Prospective Randomized Controlled Trial |
Actual Study Start Date : | May 10, 2019 |
Actual Primary Completion Date : | February 10, 2021 |
Actual Study Completion Date : | April 10, 2022 |
Arm | Intervention/treatment |
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Experimental: Pharmacist-Driven Intervention
The study group will receive a patient-tailored, pharmacist-driven intervention(s) to overcome patient-specific barriers to adherence. Each patient in the study group will be intervened upon using a protocol that is based on their reason for non-adherence.
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Behavioral: Pharmacist-Driven Intervention
The pharmacist will investigate patient assistance options for patients who cannot afford their specialty medication, reach out to prescribers when needed to address intolerance/adverse effects, improve health literacy, recommend options for forgetfulness, make every effort to reach patient, address clinical and financial barriers to unresponsiveness (lack of lab completion, not returning to clinic, etc.) |
No Intervention: Standard of Care
The usual care group will receive the standard of care provided to all patients that utilize Vanderbilt Specialty Pharmacy.
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- Median Proportion of Days Covered (PDC) at 8-months Post-enrollment [ Time Frame: 8 months post-enrollment ]Proportion of days covered (PDC) is a calculated value ranging from 0 to 1 where 1 indicates 100% adherence to medication and 0 indicates zero adherence to medication. It uses a patient's refill history to calculate the days' supply obtained over a time period (in days) divided by the time period (in days). It requires at least 2 refills.
- Median Proportion of Days Covered (PDC) at 6-months Post-enrollment [ Time Frame: 6 months post-enrollment ]Proportion of days covered (PDC) is a calculated value ranging from 0 to 1 where 1 indicates 100% adherence to medication and 0 indicates zero adherence to medication. It uses a patient's refill history to calculate the days' supply obtained over a time period (in days) divided by the time period (in days). It requires at least 2 refills.
- Reasons for Nonadherence in the Intervention Arm [ Time Frame: 35 months ]Reasons for nonadherence were obtained from a combination of electronic health records and patient-reported reasons. Since only intervention patients were contacted during this study, only reasons from the intervention arm are reported. Reasons were collected for each patient starting on the date of enrollment until 8-months post-enrollment starting from the date the study began (May 2019) until the study was complete (April 2022).
- Median Proportion of Days Covered (PDC) at 12-months Post-enrollment [ Time Frame: 12 months post-enrollment ]Proportion of days covered (PDC) is a calculated value ranging from 0 to 1 where 1 indicates 100% adherence to medication and 0 indicates zero adherence to medication. It uses a patient's refill history to calculate the days' supply obtained over a time period (in days) divided by the time period (in days). It requires at least 2 refills.
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
Ages Eligible for Study: | Child, Adult, Older Adult |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- The same medication (at the Generic Product Identifier level 12) filled ≥4 times in the 12 months before date of import into the study database
- Prescription generated from one of the following Vanderbilt outpatient specialty clinics: Pediatric Rheumatology, Pediatric Gastroenterology/Inflammatory Bowel Disease, adult Vanderbilt Rheumatology clinics, Dermatology, Hematology, Adult Endocrinology, Neurology, Asthma Sinus & Allergy, Idiopathic Pulmonary Fibrosis, Pulmonary Arterial Hypertension, Cystic Fibrosis, Multiple Sclerosis, Neurology, or a Lipid clinic
- Proportion of Days Covered (PDC) < 90% over the previous 4 months and 12 months
Exclusion Criteria:
- Prescription issued by a non-VUMC provider
- Planned treatment discontinuation in the subsequent eight months
- More than one unique specialty medication from the same clinic in the previous four months
- Patients with > 30 gap days in the previous four months and whose last fill was > 30 days from importing into the study database.
- Any reason for misidentified nonadherence in the previous four months
- Deceased patients
- Incarcerated patients
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03709277
United States, Tennessee | |
Vanderbilt University Medical Center | |
Nashville, Tennessee, United States, 37211 |
Study Director: | Autumn D Zuckerman, Pharm.D. | Vanderbilt University Medical Center |
Documents provided by Amanda Kibbons, Vanderbilt University Medical Center:
Publications:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: | Amanda Kibbons, Clinical Pharmacist, Vanderbilt University Medical Center |
ClinicalTrials.gov Identifier: | NCT03709277 |
Other Study ID Numbers: |
181452 |
First Posted: | October 17, 2018 Key Record Dates |
Results First Posted: | December 1, 2023 |
Last Update Posted: | December 1, 2023 |
Last Verified: | November 2023 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Plan Description: | IPD will not be shared |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Specialty Pharmacist Intervention |