Habit Formation for Adherence to Statin Use and LDL Reduction

NCT ID: NCT01798784

Last Updated: 2020-05-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

805 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-07-31

Study Completion Date

2017-09-30

Brief Summary

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In a 4-arm, Randomized Control Trial among members of CVS Caremark or Penn Medicine Patients with suboptimal cholesterol control who are at high risk for CVD, the study investigators propose to test the effectiveness of different behavioral economic techniques in inducing habit formation for adherence to statin use and sustained reductions in LDL cholesterol after financial incentives are discontinued. Primary outcome is changes in LDL from enrollment to 12 months (6 months after cessation of financial incentives).

Detailed Description

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Conditions

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Medication Adherence

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Control Arm

Arm 1 will be the Control arm, in which participants receive an electronic pill container and are provided with daily reminders to take their medication but are not enrolled in the sweepstakes.

Group Type NO_INTERVENTION

No interventions assigned to this group

Sweepstakes Incentive 1

Arm 2 will be a sweepstakes incentive arm where participants receive an electronic pill container and daily reminders to take their medication. In addition, this group is enrolled in a sweepstakes, in which participants may win money if they remember to take their medication.

Group Type EXPERIMENTAL

Sweepstake Incentive 1

Intervention Type BEHAVIORAL

Daily sweepstake conditional on daily medication adherence

Sweepstake Incentive 2

Arm 3 will be a sweepstake incentive arm where participants receive an electronic pill container and daily reminders to take their medication. In addition, this group is enrolled in a sweepstakes, in which monetary prizes may be awarded if participants take their medication prior to receiving a reminder.

Group Type EXPERIMENTAL

Sweepstake Incentive 2

Intervention Type BEHAVIORAL

Daily sweepstake conditional on daily medication adherence

Sweepstake Incentive 3

Arm 4 will be a sweepstake incentive arm where participants receive an electronic pill container and daily reminders to take their medication. In addition, this group is enrolled in a sweepstakes, in which each participant maintains an account that will accumulate money based on their medication adherence throughout the study.

Group Type EXPERIMENTAL

Sweepstake Incentive 3

Intervention Type BEHAVIORAL

Daily sweepstake conditional on daily medication adherence

Interventions

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Sweepstake Incentive 1

Daily sweepstake conditional on daily medication adherence

Intervention Type BEHAVIORAL

Sweepstake Incentive 2

Daily sweepstake conditional on daily medication adherence

Intervention Type BEHAVIORAL

Sweepstake Incentive 3

Daily sweepstake conditional on daily medication adherence

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Individuals at high risk of a cardiac event, specifically one of the following:
* Individuals with clinical CVD (defined as diagnosis with myocardial infarction, stroke, or peripheral vascular disease) with an LDL greater than or equal to 100 mg/dl ;
* Individuals with Diabetes (between the ages of 40-75) with an LDL greater than or equal to 100 mg/dl;
* Individuals without clinical CVD or diabetes with LDL greater than or equal to 100 mg/dl and estimated 10-year CVD risk 7.5%;
* Individuals without clinical CVD or diabetes with LDL cholesterol greater than or equal to 190 mg/dl A prescription filled for a statin medication within the last 12 months (derived from pharmacy records);
* Medication Possession Ratio (MPR) less than or equal to 80%
* Low medication adherence on self-report completed during enrollment

Exclusion Criteria

* Less than 18 years old
* Contraindication to further statin use or have suffered side effects from statins, such as myopathy
* Will not or cannot give consent
* History of active or progressive liver disease or abnormal liver function tests on baseline screening when applicable
* Currently participating in another clinical trial with related aims
* Co-morbidities likely to lead to death within a short-period
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Carnegie Mellon University

OTHER

Sponsor Role collaborator

Rutgers University

OTHER

Sponsor Role collaborator

National Institute on Aging (NIA)

NIH

Sponsor Role collaborator

University of Pennsylvania

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Kevin Volpp, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Pennsylvania

Iwan Barankay, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Pennsylvania

Peter Reese, MD, MSCE

Role: PRINCIPAL_INVESTIGATOR

University of Pennsylvania

Locations

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University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Countries

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United States

References

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Barankay I, Reese PP, Putt ME, Russell LB, Phillips C, Pagnotti D, Chadha S, Oyekanmi KO, Yan J, Zhu J, Volpp KG, Clapp JT. Qualitative Exploration of Barriers to Statin Adherence and Lipid Control: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2021 May 3;4(5):e219211. doi: 10.1001/jamanetworkopen.2021.9211.

Reference Type DERIVED
PMID: 33944923 (View on PubMed)

Russell LB, Norton LA, Pagnotti D, Sevinc C, Anderson S, Finnerty Bigelow D, Iannotte LG, Josephs M, McGilloway R, Barankay I, Putt ME, Reese PP, Asch DA, Goldberg LR, Mehta SJ, Tanna MS, Troxel AB, Volpp KG. Using Clinical Trial Data to Estimate the Costs of Behavioral Interventions for Potential Adopters: A Guide for Trialists. Med Decis Making. 2021 Jan;41(1):9-20. doi: 10.1177/0272989X20973160. Epub 2020 Nov 20.

Reference Type DERIVED
PMID: 33218296 (View on PubMed)

Barankay I, Reese PP, Putt ME, Russell LB, Loewenstein G, Pagnotti D, Yan J, Zhu J, McGilloway R, Brennan T, Finnerty D, Hoffer K, Chadha S, Volpp KG. Effect of Patient Financial Incentives on Statin Adherence and Lipid Control: A Randomized Clinical Trial. JAMA Netw Open. 2020 Oct 1;3(10):e2019429. doi: 10.1001/jamanetworkopen.2020.19429.

Reference Type DERIVED
PMID: 33034639 (View on PubMed)

Putt ME, Reese PP, Volpp KG, Russell LB, Loewenstein G, Yan J, Pagnotti D, McGilloway R, Brennen T, Finnerty D, Hoffer K, Chadha S, Barankay I. The Habit Formation trial of behavioral economic interventions to improve statin use and reduce the risk of cardiovascular disease: Rationale, design and methodologies. Clin Trials. 2019 Aug;16(4):399-409. doi: 10.1177/1740774519846852. Epub 2019 May 31.

Reference Type DERIVED
PMID: 31148473 (View on PubMed)

Other Identifiers

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5R01AG043844

Identifier Type: NIH

Identifier Source: secondary_id

View Link

1R01AG043844-01

Identifier Type: NIH

Identifier Source: org_study_id

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