Kaiser Permanente
The goal of the ADHERE-HF study is to evaluate whether care-embedded, operationally delivered digital outreach improves medication refill, adherence, and clinical outcomes among adults with heart failure who are overdue for a refill of an eligible guideline-directed medical therapy (GDMT) medication. The main question it aims to answer is: Does digital outreach using interactive text messages or automated telephone calls increase short-term refill of overdue heart failure medications compared with usual care? The study will evaluate the effectiveness of a digital outreach strategy delivered through existing health system communication channels. Members who have opted in to pharmacy text messaging will receive interactive text messages, while those who have not opted in will receive an interactive automated telephone call. The comparison group will receive usual care with no additional outreach.
Heart failure is a common chronic condition associated with hospitalization, impaired quality of life, and premature death. Guideline-directed medical therapy (GDMT) can reduce the risk of cardiovascular death and worsening heart failure, but patients must continue to refill and take these medications to receive their full benefit. Medication nonadherence remains common and contributes to a gap between the benefits observed in clinical trials and those achieved in routine care. The ADHERE-HF study is a pragmatic, prospective, open-label, individual-level randomized clinical trial designed to e…
Inclusion Criteria: 1. Age ≥18 years 2. Active KPNC membership 3. Heart failure diagnosis documented at least 6 months before the index date, with a documented EF 4. Prescribed at least one eligible GDMT medication for ≥6 months: 1. HFpEF (EF≥50%): ARNI (sacubitril/valsartan); MRA; SGLT2i 2. HFrEF or HFmrEF (EF \<50%): ARNI (sacubitril/valsartan), ACEi, or ARB; Beta-blocker (bisoprolol, carvedilol, or sustained-release metoprolol succinate); MRA; SGLT2i 5. At least one unfilled refill for an eligible GDMT medication that is 7-13 days overdue at index Exclusion Criteria: 1. Documented…
Participants assigned to this arm will receive digital outreach encouraging refill of overdue guideline-directed medical therapy (GDMT) medications for heart failure. Participants who have opted in to pharmacy text messaging at the time of outreach will receive interactive text messages. Participants who have not opted in to pharmacy text messaging will receive an interactive automated telephone call. Participants may receive additional outreach during the 12-month intervention period if another eligible GDMT medication becomes overdue.
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