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Antidepressant medication adherence via interactive voice response telephone calls.

OBJECTIVES
Outpatients given antidepressants discontinue treatment at a high rate during the first few months. We evaluated the effectiveness of Highmark's use of interactive voice response (IVR) to improve antidepressant medication adherence.


STUDY DESIGN
Quasi-experimental cohort intervention study.


METHODS
We placed 39,020 members newly given antidepressant medication into 3 intervention groups based on results of interactive voice response (IVR) call 1 month post-prescription: (1) not reached; (2) reached but not transferred to depression management consultant (DMC); and (3) reached and transferred to DMC. We evaluated medication adherence based on the Healthcare Effectiveness Data and Information Set effective acute phase (3 months) and continuation phase (6 months) treatment outcomes using member claims data. We used generalized estimating equations to model intervention effectiveness on medication adherence.


RESULTS
Adherence increased markedly with age group, with members older than 65 years having a 5.11-fold higher odds (P <.0001) of compliance than the baseline group aged 18 to 24 years. In models adjusted for time, month of intervention, and drug, the odds of compliance for groups (3) and (2) relative to group (1) were 1.34 (P = .009) and 1.19 (P <.001), respectively. In models also adjusted for age group, the group (3) and (2) odds decreased to 1.00 and 1.03 and were not statistically significant.


CONCLUSIONS
We found that IVR calls had little impact on antidepressant medication adherence rates. Adherence rates increased markedly with increasing age in each intervention group, suggesting that other intervention strategies to improve adherence should focus on the younger segment of the patient population.