Research

The development of ScriptAssist was based on a meta-analysis of more than 40 previous compliance interventions covering a 25-year period, and the implementation of a focused clinical pilot study. Our research has shown that personal, psychosocial counseling and support greatly increases patient adherence—resulting in about a 45% decrease in the level of noncompliance.

Meta-analysis

Get the entire Meta-Analysis article here.Over the last 25 years researchers have examined interventions to improve patient compliance with prescribed medications. In a review of this literature, 43 studies were identified in which researchers measured medication compliance following a specific intervention, and compared these to medication compliance levels observed under standard conditions of medical care. The average effect size for all interventions was a 35% decrease in the level of noncompliance. Interventions based on psychological techniques had a substantially greater effect, producing an average 44% decrease in the level of noncompliance. There was significant variability in the efficacy of strategies to enhance compliance: Interpersonal interventions using self-monitoring techniques, cognitive-behavioral strategies, family intervention, and assertiveness training produced the strongest results.

Pilot study

Get the entire Pilot Study here.To investigate the efficacy of a telephonically delivered nurse outreach intervention to enhance medication compliance, we conducted a pilot study in an outpatient psychiatric practice. Adult patients given a new prescription for antidepressant medication (N = 18) were randomly assigned to receive either (a) standard psychiatric care, or (b) standard care plus 5-8 follow-up telephone calls over the next 3 months. Nurses made the outreach calls on a predetermined schedule, and used psychological techniques to address risk factors for treatment attrition. Nurses also sent patients educational materials by mail. Patients who received this intervention were largely compliant (88%) up to 3 months, while significantly fewer patients in the control group (57%) remained in treatment for this long.

White Paper on Measuring Compliance

Get the white paper here.Although many different methods have been used to assess patients' compliance with prescribed medications, no single method offers 100% accuracy. The benefits and drawbacks of ten different methods are discussed in detail in this "white paper" on the assessment of noncompliance. On balance, the best available research methods for measuring medication compliance are either (a) pharmacy records on prescriptions filled and refilled, or (b) data from micro-electronic medication-container monitoring devices. However, these methods can be difficult to implement or costly to use. For routine clinical use, the measure offering the most accuracy without sacrificing cost-effectiveness involves structured clinical interviewing administered by a trained interviewer other than the treating physician. Under certain conditions (discussed below), structured clinical interviews can produce information about medication use that is 80% accurate or more.

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