Trial reportJournal of managed care & specialty pharmacy2026
The effectiveness of care coordination on medication adherence among high-need, high-cost commercially insured beneficiaries: A randomized controlled trial.
Trial report in Journal of managed care & specialty pharmacy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04415515 (Standard Care Coordination Expansion Pilot - A Quality Improvement Study), which is not on this map. Not yet cited in PubMed.
What it found
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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.
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.
Standard Care Coordination Expansion Pilot - A Quality Improvement Study
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHigh-need, high-cost (HNHC) beneficiaries experience life stressors that complicate their medication self-management. Care coordination programs may improve medication-taking behavior, including for chronic conditions that require daily medication adherence.
objectiveTo determine whether nurse-led care coordination is associated with improved adherence among an HNHC commercial population with a chronic condition.
methodsWe analyzed data from a pragmatic, national randomized controlled trial of a comprehensive care coordination program conducted by a large national insurer and assessed its impacts on medication adherence in diabetes, atrial fibrillation, and hypothyroidism. We performed intention-to-treat (ITT) analyses (primary) and instrumental variable (IV) analyses (secondary) for HNHC beneficiaries from 2019 through 2022. Analyses compared treatment of control arms for metformin in diabetes (n = 3,602), statins in diabetes (n = 3,938), direct oral anticoagulants in atrial fibrillation (n = 326), and levothyroxine in hypothyroidism (n = 2,496). The primary adherence outcome was defined as proportion of days covered (PDC) greater than or equal to 80%, with continuous adherence measured as a secondary outcome. We used multivariate regression models to compare outcomes between arms. For the IV analyses, we used randomization status as the instrument. Covariates included age, sex, geographic location, plan type, and 18 comorbidity indicators. We also conducted sensitivity analyses limited to beneficiaries with baseline PDC less than 80%.
resultsIn the primary ITT analyses, we did not observe statistically significant differences between treatment and control arms in the percentage of beneficiaries with PDC greater than or equal to 80% for metformin (66% vs 68%,
conclusionsWe found that care coordination did not improve medication adherence in HNHC beneficiaries. Our results align with prior studies and emphasize the challenges of improving adherence within a complex HNHC beneficiary population.
trial registrationClinicalTrials.gov NCT04415515.
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