UH3 Project: Personalized Patient Data and Behavioral Nudges to Improve Adherence to Chronic Cardiovascular Medications (Nudge)
Sponsoring Institution: University of Colorado
- UCHealth, Aurora, Colorado
- VA Eastern Colorado Health Care System, Aurora, Colorado
- Denver Health, Denver, Colorado
NIH Institute Providing Oversight: National Heart, Lung, and Blood Institute (NHLBI)
Program Official: Lawrence Fine (NHLBI)
Project Scientist: Nicole Redmond (NHLBI)
ClinicalTrials.gov Identifier: NCT03973931
Trial Status: Recruiting
Up to 50% of patients do not take their cardiovascular medications as prescribed, resulting in increased morbidity, mortality, and healthcare costs. Interventions to improve adherence—such as patient education, reminders, pharmacist support, and financial incentives—have produced inconsistent results due to limited study designs. Mobile and digital technologies for health promotion and disease self-management offer an opportunity to adapt behavioral “nudges” using ubiquitous mobile phone technology to facilitate medication adherence.
The Nudge Demonstration Project will use population-level pharmacy data to deliver nudges via mobile phone text messaging and an artificial intelligent (AI) interactive chat bot with the goal of improving medication adherence and patient outcomes in 3 integrated healthcare delivery systems. During the UG3 planning phase, the Nudge study will develop and pilot (1) a theoretically informed, technology-based nudge message library and (2) a chat bot content library using multiple and iterative N of 1 within-subject studies to optimize content for a range of diverse patients. Patients of interest are those with chronic cardiovascular conditions who take medications to treat hypertension, atrial fibrillation, coronary artery disease, diabetes, or hyperlipidemia. During the UG3 planning phase, pharmacy refill data will be used to identify episodes of nonadherence through gaps in medication refills. The Nudge study team plans to engage patients, providers, and health system stakeholders in designing, refining, and implementing the pilot intervention.
5/1/2019: Presentation to NIH Collaboratory Steering Committee (slides)
5/8/18: Interview with co-principal investigators Dr. Sheana Bull and Dr. Michael Ho