East Montgomery Times

In a recent study, researchers have implemented a change in prescribing habits that could significantly impact patient health management. Conducted at the Perelman School of Medicine at the University of Pennsylvania and published in JAMA Internal Medicine, the study introduced a behavioral intervention targeting doctors' default prescription settings. By changing the default prescription duration from 30 days to 90 days, the study aimed to improve statin adherence and reduce the frequency of pharmacy visits for patients.

Corinne Rhodes, MD, MPH, co-author of the study and an associate professor of General Internal Medicine, outlined the benefits of this change, stating, “For patients managing chronic conditions, this simple change just makes life easier by eliminating eight pharmacy trips annually per medication and reducing chances to be late or forgetting to refill.” This approach hopes to improve control over hypertension and related conditions treated with statins.

The study highlights a critical issue in medication adherence. Prior reports indicated patients with hardened arteries who inconsistently took their statins had a 30 percent higher mortality risk. Similarly, persistent use of statins was low, even among those with serious health conditions like diabetes.

M. Kit Delgado, MD, MS, senior author and faculty director of the Nudge Unit, commented on the intervention's potential impact, saying, “Making the right choice the easy choice is a core tenet of nudging. What’s exciting is that this small change requiring zero additional work on the part of clinicians could have such a profound impact.”

Data from the study showed an increase in doctors prescribing 90-day statin supplies from 71 percent to 91 percent over two years. This intervention also reduced the number of 30-day prescriptions by 7,200.

The successful implementation of this nudge led to its expansion to other medications, including those for blood pressure and diabetes management. Furthermore, researchers noted a reduction in demographic disparities in prescription lengths. Prior to the intervention, there were significant gaps in 90-day prescriptions among Hispanic and Black patients compared to non-Hispanic white patients. By the close of the study, these disparities were largely eliminated, with over 90 percent of all patients receiving the longer supply.

Co-author Alexander Fanaroff, MD, emphasized the intervention's significance in promoting health equity: "What makes this intervention particularly powerful is how it eliminated these disparities completely. By the study's conclusion, approximately 90 percent of patients across all demographic groups received the longer prescriptions, demonstrating how we can advance health equity without requiring additional resources."

For additional information, contact Frank Otto at 267-693-2999 or via email at Francis.Otto@pennmedicine.upenn.edu.