NCT06066541

Social Norms, Messengers, and Processing Fluency to Increase Hypertension Medication Adherence

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 65,177 (actual)
• Sponsor: Brigham and Women's Hospital · Academic / Other
• Sex: All
• Age: 65 Years – 79 Years
• Healthy volunteers: Not accepted

Summary

Medicare Advantage beneficiaries ages 65-79 and insured by Humana with at least two unique fills of hypertension medication within the 2023 calendar year and adherence level between 60 and 85% will be identified using Humana Medicare Advantage claims data. Individuals meeting these inclusion criteria will be included and, with an institutional review board approved waiver of informed consent, will be randomized to one of 6 mailed messages or control (no message). The messages will be sent by Humana and use different behavioral techniques (social norms, messenger effects, and/or processing fluency) providing their medication refill score. Humana will send a second message within 60 days of the first message noting any changes in the refill score. The primary outcome will be the average end-of-year adherence in each arm. A secondary outcome will be the proportion of study participants with end-of-year adherence greater than or equal to 80%. The study team's hypothesis is that messages using dynamic social norms, messenger effects, and processing fluency in combination will more effectively increase average end-of-year adherence level compared to usual care. Humana will conduct all study participant outreach and data analyses, which will be performed using routinely collected insurance claims data. Regulatory oversight is conducted using Humana's centralized institutional review board (IRB) of record. The work completed by Humana study staff is funded by Humana, Inc. Dr. Choudhry and his colleagues (including subaward recipients ideas42 and Tuck School of Business at Dartmouth) will provide technical and subject matter expertise related to study research design and implementation, protocol design, statistical analysis, publication (abstract, poster, manuscript) preparation and/or review, and assistance throughout the peer review process including revisions and additional analyses if necessary for this project. The work completed by study staff at Brigham and Women's Hospital, ideas42, and Tuck School of Business at Dartmouth is funded by NIA.

Conditions

• Medication Adherence
• Hypertension

Interventions

Type	Name	Description
BEHAVIORAL	Scorecard	Participants will be mailed a scorecard from Humana reporting patients' medication adherence using a "refill score."
BEHAVIORAL	Social norms	Participants will be mailed a dynamic social norms messaging (noting the proportion of Humana members improving their medication refill scores).
BEHAVIORAL	Messenger effects	Participants will be mailed a scorecard coming from the trusted messenger of a Humana-identified pharmacist taking the same medication.
BEHAVIORAL	Processing fluency	Participants will be mailed a modified scorecard increasing processing fluency through a visual metaphor of "closing the ring."

Timeline

• Start date: 2023-08-18
• Primary completion: 2023-12-31
• Completion: 2023-12-31
• First posted: 2023-10-04
• Last updated: 2025-01-14
• Results posted: 2025-01-14

Locations

1 site across 1 country: United States