Evaluation of Emails Promoting Mail-order Pharmacy

Evaluation of an Email Intervention Promoting Enrollment in Mail-order Pharmacy

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.

Study Overview

• Status: Completed
• Conditions: Health Care Utilization
• Intervention / Treatment: Behavioral: Highlighting Cost Savings and Convenience; Behavioral: Fear Appeals; Behavioral: Message about Future Healthcare Costs; Behavioral: Endorsement from a Doctor; Behavioral: Comparison Table

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 Type: Interventional
• Enrollment (Actual): 5266
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Pennsylvania
    • Danville, Pennsylvania, United States, 17822
      • Geisinger

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

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)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: Double

Number of Arms

5

Arms and Interventions

Participant Group / 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: Highlighting Cost Savings and Convenience; Email; Behavioral: Fear Appeals; Email; Behavioral: Message about Future Healthcare Costs; 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: Highlighting Cost Savings and Convenience; Email; Behavioral: Endorsement from a Doctor; 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: Highlighting Cost Savings and Convenience; Email; Behavioral: Comparison Table; Email
No Intervention: No Contact; Members do not receive an email.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mail-order Pharmacy Enrollment	Binary variable indicating if there was an enrollment in the health system's mail order pharmacy	1 week from the intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Email Opens	Binary variable indicating if the email was opened	1 week from the intervention
Email Link Click	Binary variable indicating if the link to the mail-order pharmacy website was clicked	1 week from the intervention
Email Unsubscribes	Binary variable indicating if the recipient requested to unsubscribe from receiving emails from the health system	1 week from the intervention

Collaborators and Investigators

• Sponsor: Geisinger Clinic

Study record dates

Study Major Dates

• Study Start (Actual): October 13, 2020
• Primary Completion (Actual): October 20, 2020
• Study Completion (Actual): October 20, 2020

Study Registration Dates

• First Submitted: October 6, 2020
• First Submitted That Met QC Criteria: October 7, 2020
• First Posted (Actual): October 14, 2020

Study Record Updates

• Last Update Posted (Actual): October 27, 2020
• Last Update Submitted That Met QC Criteria: October 26, 2020
• Last Verified: October 1, 2020

More Information

Terms related to this study

• Keywords: Communication; Psychology; Pharmacy; Postal Service; Electronic Mail; Economics, Behavioral; Loss Frames; Fear Appeals
• Other Study ID Numbers: 2020-0482 (Other Identifier: M D Anderson Cancer Center)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Yes
• IPD 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.
• IPD Sharing 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.
• IPD Sharing Access Criteria: The data on the Open Science Framework will be open to anyone requesting that information.
• IPD Sharing Supporting Information Type: Study Protocol; Analytic Code

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No