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‘Fresh start days’ and medication adherence

It’s common for people to look at New Year’s Day or birthdays as a chance to start a healthy behavior. But do those behaviors last? Humana recently conducted a study to test if these “fresh start days” were an opportunity to help people improve their medication adherence.

We partnered with researchers from Washington University in St. Louis and the University of Pennsylvania for the first-ever randomized controlled trial to test whether sending medication reminders around the time of fresh-start dates could boost their effectiveness.

Contrary to our expectations, the study found that reminder letters sent near fresh-start dates did not increase medication adherence. Even framing the fresh-start dates as an opportunity for positive changes did not increase reminder effectiveness, according to the study, which was published in the medical journal JAMA Cardiology.

“Medication adherence is a crucial issue when it comes to population health,” said William Fleming, president of Humana Pharmacy Solutions. “Finding what doesn’t work, can help us make progress towards finding what does work to improve medication adherence.”

The researchers, led by Hengchen Dai, PhD, of the Olin Business School at Washington University in St. Louis, contacted more than 15,000 Humana members to encourage them to take their cholesterol, diabetes, or blood pressure medications. These people were under commercial or Medicare Advantage programs and has 40-80 percent medication adherence during the previous 12 months. Some were sent reminder letters the week of their birthdays. Others were sent reminder letters three weeks after New Year’s Day. A control group was sent the reminder letters on a random day.

Researchers used pharmacy refill history to see how frequently people filled their prescriptions in the 90 days following the reminder. Contrary to our initial hypothesis, the people who received the Fresh Start reminder letters didn’t show a statistically significant improvement in their adherence compared to a control population. The timing of the reminder made no difference.

The study authors encourage further study be undertaken on how the psychology of fresh starts relates to medication adherence.

“Finding effective ways to improve members’ ability to take medication as prescribed has the potential to dramatically improve the health of individuals and communities,” said Laura Happe, director of Research and Publications at Humana. “Research like this is crucial to helping Humana serve its members while also contributing to the larger body of knowledge regarding population health.”

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