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Evaluation of Emails Promoting Mail-order Pharmacy

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT04587063
Recruitment Status : Completed
First Posted : October 14, 2020
Last Update Posted : October 27, 2020
Sponsor:
Information provided by (Responsible Party):
Amir Goren, Geisinger Clinic

Study Description
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Brief Summary:
In this evaluation, four versions of emails will be sent to eligible health plan members who are not currently enrolled in the health system's mail-order pharmacy. A control group will not receive any communication. The researchers hypothesize that the use of content informed by behavioral nudge theory in the emails should lead to increased enrollment in the health system's mail-order pharmacy.

Condition or disease Intervention/treatment Phase
Health Care Utilization Behavioral: Fear Appeals Behavioral: Message about Future Healthcare Costs Behavioral: Endorsement from a Doctor Behavioral: Comparison Table Behavioral: Highlighting Cost Savings and Convenience Not Applicable

Detailed Description:
The utilization of a mail-order pharmacy can increase adherence to medications. The health system's mail-order pharmacy (from here, simply referred to as mail-order pharmacy) can also provide reduced costs for medications. Ongoing outreach efforts involve sending emails and other communications encouraging enrollment in Geisinger's mail-order pharmacy to eligible members of the system's health plan (i.e., those who take maintenance medications). The study will compare a standard promotional email from these outreach efforts, as well as three new emails with content informed by behavioral science research, against a no-contact control arm and each other.
Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 5266 participants
Allocation: Randomized
Intervention Model: Factorial Assignment
Intervention Model Description: 1 x 5 design
Masking: Double (Participant, Care Provider)
Masking Description: Participants and providers are not aware that different mailer versions exist, and they do not know what elements in the letter are being tested.
Primary Purpose: Health Services Research
Official Title: Evaluation of an Email Intervention Promoting Enrollment in Mail-order Pharmacy
Actual Study Start Date : October 13, 2020
Actual Primary Completion Date : October 20, 2020
Actual Study Completion Date : October 20, 2020
Arms and Interventions
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Arm Intervention/treatment
Active Comparator: Standard Email
The "standard of care" email is the same as one used in prior outreach efforts at the health system, emphasizing reduced cost for medications and convenience.
 Behavioral: Highlighting Cost Savings and Convenience
Email
Experimental: Email with Healthcare Cost Savings
The email emphasizes future reductions in healthcare costs due to increased adherence with mail-order pharmacy, in addition to mentioning reduced prices for medications. It also uses fear appeals by stating the risk of hospital stays and how mail-order pharmacy could be an easily-achievable way to avoid this negative consequence.
 Behavioral: Fear Appeals
Email

Behavioral: Message about Future Healthcare Costs
Email

Behavioral: Highlighting Cost Savings and Convenience
Email
Experimental: Email with Endorsement
The email is a letter from a doctor at the health system's health plan--who may been seen as a trusted source of information--encouraging the benefits of using a mail-order pharmacy.
 Behavioral: Endorsement from a Doctor
Email

Behavioral: Highlighting Cost Savings and Convenience
Email
Experimental: Email with Comparison Table
The email includes a table comparing the benefits and drawbacks of mail-order and chain pharmacies, which appeals to their sense of agency and allows them to make the choice that best suits them.
 Behavioral: Comparison Table
Email

Behavioral: Highlighting Cost Savings and Convenience
Email
No Intervention: No Contact
Members do not receive an email.


Outcome Measures
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Primary Outcome Measures :
  1. Mail-order Pharmacy Enrollment [ Time Frame: 1 week from the intervention ]
    Binary variable indicating if there was an enrollment in the health system's mail order pharmacy


Secondary Outcome Measures :
  1. Email Opens [ Time Frame: 1 week from the intervention ]
    Binary variable indicating if the email was opened

  2. Email Link Click [ Time Frame: 1 week from the intervention ]
    Binary variable indicating if the link to the mail-order pharmacy website was clicked

  3. Email Unsubscribes [ Time Frame: 1 week from the intervention ]
    Binary variable indicating if the recipient requested to unsubscribe from receiving emails from the health system


Eligibility Criteria
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Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • An active member of the health plan (Medicare, Commercial, or Exchange)
  • Currently prescribed maintenance medications
  • Not currently subscribed to the health system's mail-order pharmacy
  • Has an email on record

Exclusion Criteria:

  • Explicitly opted out of receiving emails from the health system
  • Only has eligible current prescriptions for fewer than 28 days
  • Only has prescriptions that cannot be sent via mail-order pharmacy (e.g., antidepressants, specialty-tier drugs)
  • Is a Medicare member in the coverage gap
  • Shares an email address with another selected participant (who was randomly chosen for inclusion among all those sharing the same email address)
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04587063


Locations
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United States, Pennsylvania
Geisinger
Danville, Pennsylvania, United States, 17822
Sponsors and Collaborators
Geisinger Clinic
Investigators
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Principal Investigator: Amir Goren, PhD Geisinger Clinic
More Information
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Responsible Party: Amir Goren, Program Director, Behavioral Insights Team, Geisinger Clinic
ClinicalTrials.gov Identifier: NCT04587063    
Other Study ID Numbers: 2020-0482
First Posted: October 14, 2020    Key Record Dates
Last Update Posted: October 27, 2020
Last Verified: October 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: Data with no personally identifiable information will be made available to other researchers on the Open Science Framework for transparency. This will include the essential data and code needed to replicate the analysis that yielded reported findings. The PI did not examine or analyze any data from this study prior to this registration.
Supporting Materials: Study Protocol
Analytic Code
Time Frame: The data will become available after publication of study results in a scientific journal and will be available as long as the Open Science Framework hosts the data.
Access Criteria: The data on the Open Science Framework will be open to anyone requesting that information.

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Amir Goren, Geisinger Clinic:
Pharmacy
Postal Service
Electronic Mail
Communication
 Economics, Behavioral
Psychology
Loss Frames
Fear Appeals