Evidence map›Paper›PMID 29625571›Full record

ArticleBMC health services research2018

Language-concordant automated telephone queries to assess medication adherence in a diverse population: a cross-sectional analysis of convergent validity with pharmacy claims.

Neda Ratanawongsa, Judy Quan, Margaret A Handley, Urmimala Sarkar, Dean Schillinger

Registry-linked trialOpen access · goldAbstract readValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00683020 (Harnessing Health IT for Self-Management Support and Medication Activation in a Medicaid Health Plan), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.0field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00683020 nacompletednot on this map

Harnessing Health IT for Self-Management Support and Medication Activation in a Medicaid Health Plan

TypeinterventionalSponsorUniversity of California, San FranciscoRan2009 to 2012Enrolled362ConditionsDiabetesArmsATSM Intervention
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 2 countries.

Neda RatanawongsaGeneral Internal Medicine and UCSF Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center, University of California, 1001 Potrero Avenue, Box 1364, San Francisco, CA, 94143, USA. Neda.ratanawongsa@ucsf.edu.ORCID 0000-0001-9944-6923
Judy QuanGeneral Internal Medicine and UCSF Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center, University of California, 1001 Potrero Avenue, Box 1364, San Francisco, CA, 94143, USA.
Margaret A HandleyGeneral Internal Medicine and UCSF Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center, University of California, 1001 Potrero Avenue, Box 1364, San Francisco, CA, 94143, USA.
Urmimala SarkarGeneral Internal Medicine and UCSF Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center, University of California, 1001 Potrero Avenue, Box 1364, San Francisco, CA, 94143, USA.
Dean SchillingerGeneral Internal Medicine and UCSF Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center, University of California, 1001 Potrero Avenue, Box 1364, San Francisco, CA, 94143, USA.
San Francisco General Hospital · US

Funding

UCSF CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTEUL1RR024131 · NCRR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JOHNSTON, S. CLAIBORNE · 2006 to 2011
$111.2M
COLLABORATIVE CHRONIC DISEASE, HEALTH PROMOTION AND SURVEILLANCE PROGRAMU58DP002007 · DP · CALIFORNIA STATE DEPT OF PUBLIC HEALTH · PI PECK, CAROLINE ANNE · 2009 to 2014
$24.7M
Clinical and Transtional Science InstituteKL2TR000143 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GRANDIS, JENNIFER RUBIN · 2012 to 2015
$11.9M
Translational Research Core - Health Engagement & Action Translational (HEAT)P30DK092924 · NIDDK · KAISER FOUNDATION RESEARCH INSTITUTE · PI Alyce Sophia Adams, HILARY Kessler SELIGMAN · 2011 to 2026
$9.2M
Building an Ambulatory Patient Safety Learning Laboratory for Diverse PopulationsP30HS023558 · AHRQ · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SARKAR, URMIMALA · 2014 to 2017
$3.9M
The Next Frontier in Diabetes Communication: Promoting Health Literacy in the Era of Secure MessagingR01LM012355 · NLM · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KARTER, ANDREW JOHN, SCHILLINGER, DEAN · 2015 to 2018
$2.8M
Harnessing Health IT for Self-Management Support and Medication Activation in a MR18HS017261 · AHRQ · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SCHILLINGER, DEAN · 2007 to 2009
$1.1M
Integrating Adherence into a Safety Net EHR Tool to Improve Decision-makingK08HS022561 · AHRQ · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI RATANAWONGSA, NEDA · 2014 to 2017
$621k
Implementation Outcomes of a Health IT Program For Vulnerable Diabetes PatientsR03HS020684 · AHRQ · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HANDLEY, MARGARET ANNE · 2011 to 2011
$100k
Agency for Healthcare Research and Quality 1K08HS022561Agency for Healthcare Research and Quality 1R03HS020684Agency for Healthcare Research and Quality R18HS017261AHRQ HHS K08 HS022561AHRQ HHS P30 HS023558AHRQ HHS R03 HS020684AHRQ HHS R18 HS017261CDC HHS 5U58DP002007NCATS NIH HHS KL2 TR000143NCCDPHP CDC HHS U58 DP002007NCRR NIH HHS UL1 RR024131NIDDK NIH HHS 1P30-DK092924NIDDK NIH HHS P30 DK092924NLM NIH HHS R01 LM012355
6 · The paper itself

Abstract

backgroundClinicians have difficulty accurately assessing medication non-adherence within chronic disease care settings. Health information technology (HIT) could offer novel tools to assess medication adherence in diverse populations outside of usual health care settings. In a multilingual urban safety net population, we examined the validity of assessing adherence using automated telephone self-management (ATSM) queries, when compared with non-adherence using continuous medication gap (CMG) on pharmacy claims. We hypothesized that patients reporting greater days of missed pills to ATSM queries would have higher rates of non-adherence as measured by CMG, and that ATSM adherence assessments would perform as well as structured interview assessments.

methodsAs part of an ATSM-facilitated diabetes self-management program, low-income health plan members typed numeric responses to rotating weekly ATSM queries: "In the last 7 days, how many days did you MISS taking your …" diabetes, blood pressure, or cholesterol pill. Research assistants asked similar questions in computer-assisted structured telephone interviews. We measured continuous medication gap (CMG) by claims over 12 preceding months. To evaluate convergent validity, we compared rates of optimal adherence (CMG ≤ 20%) across respondents reporting 0, 1, and ≥ 2 missed pill days on ATSM and on structured interview.

resultsAmong 210 participants, 46% had limited health literacy, 57% spoke Cantonese, and 19% Spanish. ATSM respondents reported ≥1 missed day for diabetes (33%), blood pressure (19%), and cholesterol (36%) pills. Interview respondents reported ≥1 missed day for diabetes (28%), blood pressure (21%), and cholesterol (26%) pills. Optimal adherence rates by CMG were lower among ATSM respondents reporting more missed days for blood pressure (p = 0.02) and cholesterol (p < 0.01); by interview, differences were significant for cholesterol (p = 0.01).

conclusionsLanguage-concordant ATSM demonstrated modest potential for assessing adherence. Studies should evaluate HIT assessments of medication beliefs and concerns in diverse populations.

trial registrationNCT00683020 , registered May 21, 2008.

Indexed as

LanguageMedication AdherenceSelf CareTelephoneChronic DiseaseCross-Sectional StudiesDiabetes MellitusFemaleHealth LiteracyHealth Status DisparitiesHumansInsurance Claim ReviewInterviews as TopicMaleMiddle AgedPharmaceutical ServicesDiabetesHealth disparitiesHealth information technologyLimited English proficiencyLimited health literacyManaged careMedicaidMedication adherenceSafety net clinics

Identifiers

PMID29625571
PMCPMC5889590
OpenAlexW2804074510

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.