This document discusses using interactive voice response (IVR) technology to improve statin adherence through targeted communications. It summarizes a statin adherence program at Kaiser Permanente Riverside that used IVR reminder calls, a barrier survey, and mail order options. The program reached 88% of the target population and 71% heard messages. It found the main barriers to adherence were not knowing to refill, cost, and convenience issues. Targeted messaging increased adherence, with 27% of those initially not intending to refill doing so after barrier messages. The program demonstrated how data and continuous improvement can enhance IVR's ability to personalize outreach at scale.
9. Population vs. High‐Risk Approach
10
Percent of Population
Percent of Population
10
8
6
4
2
0
200
300
Serum Cholesterol Level (mg/DL)
•
•
•
6
4
2
0
100
•
8
400
100
200
300
400
Serum Cholesterol Level (mg/DL)
Risk factors, such as cholesterol or blood pressure, have a wide bell‐shaped distribution, with a “tail”
of high values.
The “high‐risk approach” involves identification and intensive treatment of those at the high end of
the “tail”, often at greatest risk of CVD, reducing levels to “normal”.
Most cases of CVD do not occur among the highest levels of a given risk factor, and in fact, occur
among those in the “average” risk group.
Significant reduction in the population burden of CVD can occur only from a “population approach”,
shifting the entire population distribution to lower levels.
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19. Southern California Kaiser Statin
Adherence Program
Objectives
Initial Steps
• Interactive yet cost effective
• Literature review
– If interaction is needed, it has to • Survey target population
be mostly automated
• Develop IVR messaging in
• Sustainable and scalable to all
collaboration with Silverlink:
of Kaiser Southern California
– PDCA cycles to improve the
• Universally applicable
‘listen’ rate
– Computer & reading literacy
– Cultural & language sensitive
– Individualized communications
– Address barriers to adherence
• Increase adherence and
improve clinical outcomes
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