Refinement and Testing of Recruitment Methodology for Behavioral Medication Adherence Interventions Using Behavioral Science-based Approaches

NCT ID: NCT06569290

Last Updated: 2025-03-06

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

RECRUITING

Clinical Phase

NA

Total Enrollment

584 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-03-03

Study Completion Date

2026-04-30

Brief Summary

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The overarching goal of the proposed research is to prepare the clinical pharmacist intervention for sustainable implementation and dissemination. Because the effectiveness of the intervention has already been demonstrated in a NIH Stage Model IV trial, the investigators propose an Effectiveness-Implementation Type 3 Hybrid design, in which the primary focus is on testing different implementation methods, while secondarily observing clinical effects. The investigators' overarching hypothesis is to identify the most impactful elements of a behavioral theory-informed recruitment approach, which can be replicable across clinical settings.

Accordingly, the investigators propose to perform testing of a behaviorally-informed recruitment approaches in a community-based setting. Like the previous Tele-Pharmacy Intervention to Improve Treatment Adherence (STIC2IT) trial (NCT02512276), participants will be English or Spanish speaking adults ≥18 years of age identified through the electronic health record (EHR) as having poor disease control and/or poor medication adherence for diabetes. The primary care physicians of eligible patients identified through the EHR will be contacted to opt-out any patients they wish not to be included. Patients will then be randomized to each of the following conditions, such that there will be 8 total arms: (1) inclusion of a mailer primer (yes/no), (2) the most successful recruitment letter from the preliminary study using prospect theory (versus the control letter), and (3) intensity of the intervention outreach (4 calls vs. 2 calls). The investigators plan to enroll 584 participants who meet the inclusion criteria, with 73 patients per each of the 8 study arms.

Patients across all arms who agree to be scheduled will receive an appointment with one of the clinical pharmacists within the established BMC pharmacist program. The primary outcome will be completion of a clinical pharmacist appointment within 8 weeks after randomization. Key secondary outcomes will include scheduled visit rates, no-show rates for scheduled appointments, medication adherence over the 3-month follow-up, and clinical outcomes, including HbA1c levels measured using EHR data in the 3 months after randomization. The medication adherence and clinical outcomes will be used for the Aim 2 evaluation.

Detailed Description

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Conditions

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Diabetes Pharmacist-Patient Relations Medication Adherence

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

DOUBLE

Investigators Outcome Assessors
Principal investigators and data analysts will be masked to group assignment when analyzing data to determine the effectiveness of the recruitment strategy.

Study Groups

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Arm 1

Post card; control letter; 2 calls

Group Type ACTIVE_COMPARATOR

Primer postcard

Intervention Type BEHAVIORAL

Inclusion of a mailed primer post card

Control recruitment letter

Intervention Type BEHAVIORAL

a recruitment letter without any behaviorally-informed language

2 phone calls

Intervention Type BEHAVIORAL

2 recruitment phone calls made by the call center

Arm 2

Post card; control letter; 4 calls

Group Type ACTIVE_COMPARATOR

Primer postcard

Intervention Type BEHAVIORAL

Inclusion of a mailed primer post card

Control recruitment letter

Intervention Type BEHAVIORAL

a recruitment letter without any behaviorally-informed language

4 phone calls

Intervention Type BEHAVIORAL

4 recruitment phone calls made by the call center

Arm 3

Post card; behavioral letter; 2 calls

Group Type ACTIVE_COMPARATOR

Primer postcard

Intervention Type BEHAVIORAL

Inclusion of a mailed primer post card

Behavioral theory-informed recruitment letter (prospect theory)

Intervention Type BEHAVIORAL

the recruitment letter will use prospect theory and deliver a low risk, gain-framed behaviorally-informed message.

2 phone calls

Intervention Type BEHAVIORAL

2 recruitment phone calls made by the call center

Arm 4

Post card; behavioral letter; 4 calls

Group Type ACTIVE_COMPARATOR

Primer postcard

Intervention Type BEHAVIORAL

Inclusion of a mailed primer post card

Behavioral theory-informed recruitment letter (prospect theory)

Intervention Type BEHAVIORAL

the recruitment letter will use prospect theory and deliver a low risk, gain-framed behaviorally-informed message.

4 phone calls

Intervention Type BEHAVIORAL

4 recruitment phone calls made by the call center

Arm 5

No post card; control letter; 2 calls

Group Type ACTIVE_COMPARATOR

Control recruitment letter

Intervention Type BEHAVIORAL

a recruitment letter without any behaviorally-informed language

2 phone calls

Intervention Type BEHAVIORAL

2 recruitment phone calls made by the call center

Arm 6

No post card; control letter; 4 calls

Group Type ACTIVE_COMPARATOR

Control recruitment letter

Intervention Type BEHAVIORAL

a recruitment letter without any behaviorally-informed language

4 phone calls

Intervention Type BEHAVIORAL

4 recruitment phone calls made by the call center

Arm 7

No post card; behavioral letter; 2 calls

Group Type ACTIVE_COMPARATOR

Behavioral theory-informed recruitment letter (prospect theory)

Intervention Type BEHAVIORAL

the recruitment letter will use prospect theory and deliver a low risk, gain-framed behaviorally-informed message.

2 phone calls

Intervention Type BEHAVIORAL

2 recruitment phone calls made by the call center

Arm 8

No post card; behavioral letter; 4 calls

Group Type ACTIVE_COMPARATOR

Behavioral theory-informed recruitment letter (prospect theory)

Intervention Type BEHAVIORAL

the recruitment letter will use prospect theory and deliver a low risk, gain-framed behaviorally-informed message.

4 phone calls

Intervention Type BEHAVIORAL

4 recruitment phone calls made by the call center

Interventions

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Primer postcard

Inclusion of a mailed primer post card

Intervention Type BEHAVIORAL

Control recruitment letter

a recruitment letter without any behaviorally-informed language

Intervention Type BEHAVIORAL

Behavioral theory-informed recruitment letter (prospect theory)

the recruitment letter will use prospect theory and deliver a low risk, gain-framed behaviorally-informed message.

Intervention Type BEHAVIORAL

2 phone calls

2 recruitment phone calls made by the call center

Intervention Type BEHAVIORAL

4 phone calls

4 recruitment phone calls made by the call center

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* ≥18 years of age
* English or Spanish speaking
* Receiving care from a BMC primary care provider
* Non-adherent to prescribed oral glucose-lowering medications as per pharmacy dispense records (proportion of days covered \<80% to at least one eligible medication in last 6 months)
* Evidence of poor or worsening disease control

Exclusion Criteria

* Evidence of terminal conditions
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute on Aging (NIA)

NIH

Sponsor Role collaborator

Boston Medical Center

OTHER

Sponsor Role collaborator

Columbia University

OTHER

Sponsor Role collaborator

Brigham and Women's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Niteesh K. Choudhry, MD, PhD

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Niteesh K Choudhry, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Brigham and Women's Hospital

Locations

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Boston Medical Center

Boston, Massachusetts, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Niteesh K Choudhry, MD, PhD

Role: CONTACT

(617) 278-0930

Michael M Fischer, MD, MS

Role: CONTACT

Facility Contacts

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Michael Fischer, MD, MS

Role: primary

617-414-7288

Other Identifiers

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5P30AG064199-05

Identifier Type: NIH

Identifier Source: secondary_id

View Link

2024P002222

Identifier Type: -

Identifier Source: org_study_id

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