ADHERE-ASCVD
Adherence to Dyslipidemia Therapy: Harnessing Evidence From Randomized Evaluations in AtheroSclerotic CardioVascular Disease
Patient / Population Intervention / Exposure Comparison Outcome
In 22,000 statin-non-adherent patients with cardiovascular disease or diabetes, adaptive digital outreach was compared with usual care on a statin refill within 14 days.
N
22,000
Design
pragmatic two-stage sequential multiple assignment randomised trial (SMART) embedded in Kaiser Permanente Northern California; first-stage randomisation to outreach by SMS, secure patient-portal message, non-secure e-mail, or usual care; non-refillers at 14 days re-randomised to the same or a different channel or usual care (13 sequences in total); care providers, investigators and outcome assessors masked; refills ascertained from pharmacy dispensing records; persistence and adherence tracked to 12 months
Endpoint
Proportion of participants who refill a statin prescription within 14 days of message delivery, after the first-stage outreach and, among non-responders, after the second-stage outreach