Ashli A Owen-Smith1, David H Smith2, Cynthia S Rand3, Jeffrey O Tom4, Reesa Laws5, Amy Waterbury6, Andrew Williams7, William M Vollmer8. 1. Assistant Professor of Health Management and Policy at the Georgia State University School of Public Health in Atlanta. aowensmith@gsu.edu. 2. Senior Investigator at The Kaiser Permanente Center for Health Research in Portland, OR. david.h.smith@kpchr.org. 3. Professor of Medicine in the Department of Medicine at the Johns Hopkins School of Medicine in Baltimore, MD. crand@jhmi.edu. 4. Assistant Clinical Professor in the Department of Pediatrics at the University of Hawaii John A Burns School of Medicine in Honolulu. jotom@hawaii.edu. 5. Research and Data Analytics Center Manager and Technical Research Program Manager at The Kaiser Permanente Center for Health Research in Portland, OR. reesa.laws@kpchr.org. 6. Research Program Manager at The Kaiser Permanente Center for Health Research in Portland, OR. amy.waterbury@kpchr.org. 7. Faculty Scientist in the Center for Outcomes Research and Evaluation at the Maine Medical Center Research Institute in Scarborough. aewilliams@mmc.org. 8. Senior Investigator at The Kaiser Permanente Center for Health Research in Portland, OR. william.vollmer@kpchr.org.
Abstract
CONTEXT: There is little research investigating whether health information technologies, such as interactive voice recognition, are effective ways to deliver information to individuals with lower health literacy. OBJECTIVE: Determine the extent to which the impact of an interactive voice recognition-based intervention to improve medication adherence appeared to vary by participants' health literacy level. DESIGN: Promoting Adherence to Improve Effectiveness of Cardiovascular Disease Therapies (PATIENT) was a randomized clinical trial designed to test the impact, compared with usual care, of 2 technology-based interventions that leveraged interactive voice recognition to promote medication adherence. A 14% subset of participants was sent a survey that included questions on health literacy. This exploratory analysis was limited to the 833 individuals who responded to the survey and provided data on health literacy. MAIN OUTCOME MEASURES: Adherence to statins and/or angiotensin-converting enzyme inhibitors and/or angiotensin II receptor blockers. RESULTS: Although intervention effects did not differ significantly by level of health literacy, the data were suggestive of differential intervention effects by health literacy level. CONCLUSIONS: The differences in intervention effects for high vs low health literacy in this exploratory analysis are consistent with the hypothesis that individuals with lower health literacy may derive greater benefit from this type of intervention compared with individuals with higher health literacy. Additional studies are needed to further explore this finding.
RCT Entities:
CONTEXT: There is little research investigating whether health information technologies, such as interactive voice recognition, are effective ways to deliver information to individuals with lower health literacy. OBJECTIVE: Determine the extent to which the impact of an interactive voice recognition-based intervention to improve medication adherence appeared to vary by participants' health literacy level. DESIGN: Promoting Adherence to Improve Effectiveness of Cardiovascular Disease Therapies (PATIENT) was a randomized clinical trial designed to test the impact, compared with usual care, of 2 technology-based interventions that leveraged interactive voice recognition to promote medication adherence. A 14% subset of participants was sent a survey that included questions on health literacy. This exploratory analysis was limited to the 833 individuals who responded to the survey and provided data on health literacy. MAIN OUTCOME MEASURES: Adherence to statins and/or angiotensin-converting enzyme inhibitors and/or angiotensin II receptor blockers. RESULTS: Although intervention effects did not differ significantly by level of health literacy, the data were suggestive of differential intervention effects by health literacy level. CONCLUSIONS: The differences in intervention effects for high vs low health literacy in this exploratory analysis are consistent with the hypothesis that individuals with lower health literacy may derive greater benefit from this type of intervention compared with individuals with higher health literacy. Additional studies are needed to further explore this finding.
Authors: Alexander S Misono; Sarah L Cutrona; Niteesh K Choudhry; Michael A Fischer; Margaret R Stedman; Joshua N Liberman; Troyen A Brennan; Sachin H Jain; William H Shrank Journal: Am J Manag Care Date: 2010-12 Impact factor: 2.229
Authors: J A Gazmararian; D W Baker; M V Williams; R M Parker; T L Scott; D C Green; S N Fehrenbach; J Ren; J P Koplan Journal: JAMA Date: 1999-02-10 Impact factor: 56.272
Authors: Anjali U Pandit; Joyce W Tang; Stacy Cooper Bailey; Terry C Davis; Mary V Bocchini; Stephen D Persell; Alex D Federman; Michael S Wolf Journal: Patient Educ Couns Date: 2009-05-12