title: Difference in Effectiveness of Medication Adherence Intervention by Health Literacy Level.
abstract: There is little research investigating whether health information technologies, such as interactive voice recognition, are effective ways to deliver information to individuals with lower health literacy.
  
  
  
  Determine the extent to which the impact of an interactive voice recognition-based intervention to improve medication adherence appeared to vary by participants' health literacy level.
  
  
  
  Promoting Adherence to Improve Effectiveness of Cardiovascular Disease Therapies (PATIENT) was a randomized clinical trial designed to test the impact, compared with usual care, of 2 technology-based interventions that leveraged interactive voice recognition to promote medication adherence. A 14% subset of participants was sent a survey that included questions on health literacy. This exploratory analysis was limited to the 833 individuals who responded to the survey and provided data on health literacy.
  
  
  
  Adherence to statins and/or angiotensin-converting enzyme inhibitors and/or angiotensin II receptor blockers.
  
  
  
  Although intervention effects did not differ significantly by level of health literacy, the data were suggestive of differential intervention effects by health literacy level.
  
  
  
  The differences in intervention effects for high vs low health literacy in this exploratory analysis are consistent with the hypothesis that individuals with lower health literacy may derive greater benefit from this type of intervention compared with individuals with higher health literacy. Additional studies are needed to further explore this finding.
authors.affiliation: Assistant Professor of Health Management and Policy at the Georgia State University School of Public Health in Atlanta. aowensmith@gsu.edu.
authors.forename: Ashli A
authors.initials: AA
authors.lastname: Owen-Smith
authors.affiliation: Senior Investigator at The Kaiser Permanente Center for Health Research in Portland, OR. david.h.smith@kpchr.org.
authors.forename: David H
authors.initials: DH
authors.lastname: Smith
authors.affiliation: Professor of Medicine in the Department of Medicine at the Johns Hopkins School of Medicine in Baltimore, MD. crand@jhmi.edu.
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Rand
authors.affiliation: Assistant Clinical Professor in the Department of Pediatrics at the University of Hawaii John A Burns School of Medicine in Honolulu. jotom@hawaii.edu.
authors.forename: Jeffrey O
authors.initials: JO
authors.lastname: Tom
authors.affiliation: Research and Data Analytics Center Manager and Technical Research Program Manager at The Kaiser Permanente Center for Health Research in Portland, OR. reesa.laws@kpchr.org.
authors.forename: Reesa
authors.initials: R
authors.lastname: Laws
authors.affiliation: Research Program Manager at The Kaiser Permanente Center for Health Research in Portland, OR. amy.waterbury@kpchr.org.
authors.forename: Amy
authors.initials: A
authors.lastname: Waterbury
authors.affiliation: Faculty Scientist in the Center for Outcomes Research and Evaluation at the Maine Medical Center Research Institute in Scarborough. aewilliams@mmc.org.
authors.forename: Andrew
authors.initials: A
authors.lastname: Williams
authors.affiliation: Senior Investigator at The Kaiser Permanente Center for Health Research in Portland, OR. william.vollmer@kpchr.org.
authors.forename: William M
authors.initials: WM
authors.lastname: Vollmer
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000188:drug therapy; D005260:Female; D057220:Health Literacy; D006293:Health Promotion; D006801:Humans; D008297:Male; D008490:Medical Informatics; D055118:Medication Adherence; D008875:Middle Aged; D015397:Program Evaluation; D011795:Surveys and Questionnaires