UnitedHealth Group Inc. : Text Message Prescription Reminders Significantly Improve Patient Adherence to Oral Diabetes Medication

Study shows that text message reminders can be effective in diabetes treatment, even for patients over 60

A new study published in the May issue of Clinical Therapeutics shows that patients who participate in a text message prescription reminder program have significantly higher adherence to chronic oral medications than those in a control group.

The study of 580 employer-sponsored and Medicare members of a national pharmacy benefit manager (PBM) found that patients receiving text message reminders had better medication adherence rates than those who did not - 85 percent vs. 77 percent. The adherence rates for those taking chronic anti-diabetes medication were even higher - 91 percent vs. 82 percent. Medication adherence is defined as the extent to which patients take their medications as instructed by a physician.

This is the first large-scale study in the United States to examine if a text message program providing medication-specific reminders could increase adherence. Previous research has shown a similar positive impact; however, these studies were smaller in scope, often with fewer than 100 participants, and focused on homogenous patient groups, such as those who are being treated for the same disease.

"This research provides strong evidence that technology can play a vital role in improving medication adherence, even among older patients," said Brian K. Solow, M.D., chief medical officer, OptumRx. "This is of great importance to all stakeholders in health care because poor medication adherence can lead to inferior treatment outcomes, higher hospitalization rates and increased health care costs."

OptumRx's text messaging adherence program - called My Medication Reminders - was studied between Sept. 15, 2010, and Aug. 31, 2011. With My Medication Reminders, participants can opt to provide their mobile phone number, mobile carrier and time zone, and select any combination of reminder choices: Refill; Renewals; Prescription Transfer; Order Shipped; General Daily Medication Reminder; and Prescription Specific Dosage Reminders. Those eligible for inclusion in the study opted to receive at least one prescription specific dosage reminder for chronic oral medication. These text message reminders can be set for active prescription drugs as well as over-the-counter medications, and consumers can specify how often they wish to receive the reminders.

"Text messages and emerging technologies offer new opportunities to educate and engage patients so they can improve their health and ultimately rein in their health care costs," said Kalee Foreman, Pharm.D, OptumRx, lead author of the study. "A study in the New England Journal of Medicine found that nearly 70 percent of medication-related hospital admissions in the United States are due to poor medication adherence, costing the health care system roughly $100 billion per year."

In the study, medication adherence was measured by "proportion of days covered" (PDC; a measurement that examines each day in period to determine if the patient has the drug on hand) between Jan. 1, 2011, and Aug. 1, 2011. After implementation of the text message program, participants who took a chronic oral antidiabetes medication had a significantly higher mean PDC than the control group (0.91 [0.14] vs. 0.82 [0.21]). Significant differences in mean PDC were also seen in those who opted to receive text message reminders for beta-blocker therapy over those in the control cohort (0.88 [0.18] vs. 0.71 [0.29]). For all patients studied, the mean PDC was significantly higher for the text message cohort than for the control cohort (0.85 [0.20] vs. 0.77 [0.28]).

The study authors noted that additional research is needed to determine if text messaging improves medication adherence in patients known to be non-adherent, as well as long-term medication adherence rates.

Study Design and Population
The cohort analysis was conducted using OptumRx's consumer web-portal database and electronic pharmacy claims. The study population consisted of continuously enrolled members of an OptumRx employer-sponsored, Medicare prescription drug plan (PDP), or Medicare Advantage Prescription Drug (MA-PD) plan from Jan. 1, 2010, through Aug. 31, 2011. Patients were eligible for inclusion in the text message reminder cohort if they had opted to receive at least one medication-specific dosage reminder for a chronic oral medication of interest and had at least one pharmacy claim for the same chronic oral medication of interest between Sept. 15, 2010, and Dec. 31, 2010.

About OptumRx
OptumRx is part of Optum, a leading information and technology-enabled health services company dedicated to making the health system work better for everyone. Prescription Solutions by OptumRx is an innovative pharmacy benefit management organization managing the prescription drug benefits of commercial, Medicare and other governmental health plans, as well as those of employers and unions through a national network of 64,000 community pharmacies and state-of-the-art mail service pharmacies in California and Kansas, both of which have earned the prestigious Verified Internet Pharmacy Practice Sites™ (VIPPS®) accreditation by the National Association of Boards of Pharmacy®. Visit www.optum.com or www.prescriptionsolutions.com for more information.

About Optum
Optum is a leading information and technology-enabled health services business dedicated to making the health system work better for everyone. Optum is comprised of three companies - OptumHealth, OptumInsight and OptumRx - representing more than 30,000 employees worldwide who collaborate to deliver intelligent solutions that modernize the health system, improve overall population health and support Sustainable Health Communities. Optum serves the broad health care marketplace, including care providers, plan sponsors, government agencies, life sciences companies and consumers.

OptumRx
David Himmel, 714-226-3772
david.himmel@optum.com

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