CVS Caremark Sponsored Research Finds Targeted Adherence Interventions to be More Effective than Broad Adherence Education

Thursday, May 24, 2012

Interventions targeted at cardiovascular patients identified as nonadherent were more likely to lead to improved adherence than interventions offered to all patients

WOONSOCKET, R.I., May 24, 2012 /PRNewswire/ -- New research sponsored by CVS Caremark found that adherence interventions targeted to patients identified as nonadherent were more effective than broad interventions that cast a wide net to encompass all medication takers. In fact, more than one-third of adherence interventions targeted to nonadherent patients resulted in improved medication adherence as compared to 18 percent of broad interventions.

"While medication nonadherence is widely recognized as a major public health issue that impacts patient health and contributes to rising health care costs, there has not been a clear consensus about how best to influence patient behavior and support appropriate medication use," said Sarah Cutrona, MD, MPH a former research associate at Brigham and Women's Hospital. "These results suggest that broad interventions, which aim to prevent nonadherence by educating and motivating all patients, were the least effective. Without the benefit of identifying patients and their specific barriers to adherence, these types of interventions may be too general to motivate individual patients to change their medication taking behavior."

The study, entitled "Targeting Cardiovascular Medication Adherence Interventions," was conducted by researchers at Harvard University, Brigham and Women's Hospital and CVS Caremark and was published in the May/June issue of the Journal of the American Pharmacists Association ( The researchers reviewed nearly 60 peer-reviewed articles about randomized controlled trials for three types of interventions to improve medication adherence for cardiovascular disease or diabetes. These interventions included: broad interventions targeting all patients, focused interventions targeting nonadherent patients and dynamic interventions initially administered to all patients but then targeted to nonadherent patients based on real-time adherence information. Results found that dynamic interventions (32 percent) and focused interventions (25 percent) were more likely to show impact on adherence as compared to broad interventions (18 percent).

"This study is part of our ongoing research collaboration with Harvard and Brigham and Women's Hospital to better understand the factors that impact mediation adherence," said Troyen A. Brennan, MD, MPH, executive vice president and chief medical officer of CVS Caremark, who heads the research initiative that conducted the study. "As a pharmacy innovation company we believe these results can be useful in helping to develop and better target adherence interventions so they are relevant for the patient and enable them to make better choices about their medications and achieve positive health outcomes."

The researchers concluded that targeting patients who are nonadherent to their cardiovascular medications may lead to better adherence, but more research is needed to determine how best to identify and intervene with nonadherent patients. The accuracy, cost and reproducibility of methods for identifying target populations should be a central consideration in future studies, especially in an environment where resources are limited and health care professionals and payors need to identify the most cost-effective and impactful ways to intervene and affect positive behavior change.

This study is a product of a research collaboration between CVS Caremark, Harvard and Brigham and Women's Hospital that is focused on understanding why many consumers do not take their prescriptions as directed, and developing solutions to assist patients in using their medications effectively. Excess health care costs due to medication non-adherence in the U.S. are estimated to be as much as $300 billion annually.

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About CVS Caremark

CVS Caremark is dedicated to helping people on their path to better health as the largest integrated pharmacy company in the United States. Through the company's more than 7,300 CVS/pharmacy stores; its leading pharmacy benefit manager serving more than 60 million plan members; and its retail health clinic system, the largest in the nation with more than 600 MinuteClinic locations, it is a market leader in mail order, retail and specialty pharmacy, retail clinics, and Medicare Part D Prescription Drug Plans. As a pharmacy innovation company with an unmatched breadth of capabilities, CVS Caremark continually strives to improve health and lower costs by developing new approaches such as its unique Pharmacy Advisor program that helps people with chronic diseases such as diabetes obtain and stay on their medications. Find more information about how CVS Caremark is reinventing pharmacy for better health at

Media Contact:
Christine Cramer
CVS Caremark
(401)770 3317