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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">IPROC</journal-id>
      <journal-id journal-id-type="nlm-ta">iproc</journal-id>
      <journal-title>Iproceedings</journal-title>
      <issn pub-type="epub">2369-6893</issn>
      <publisher>
        <publisher-name>JMIR Publications</publisher-name>
        <publisher-loc>Toronto, Canada</publisher-loc>
      </publisher>
    </journal-meta>
    <article-meta>
    <article-id pub-id-type="publisher-id">v3i1e13</article-id>
    <article-id pub-id-type="pmid"/>
    <article-id pub-id-type="doi">10.2196/iproc.8427</article-id>
    <article-categories>
      <subj-group subj-group-type="heading">
        <subject>Abstract</subject>
      </subj-group>
      <subj-group subj-group-type="article-type">
        <subject>Abstract</subject>
      </subj-group>
    </article-categories>
    <title-group>
      <article-title>Impact of AllazoEngine-Targeted Interventions on Medication Adherence: Repeated Measures Difference-in-Differences Analysis</article-title>
    </title-group>
    <contrib-group>
      <contrib contrib-type="editor">
        <name>
          <surname>Hale</surname>
          <given-names>Timothy</given-names>
        </name>
      </contrib>
    </contrib-group>
    <contrib-group>
      <contrib contrib-type="author" id="contrib1">
        <name name-style="western">
          <surname>Gracey</surname>
          <given-names>Brittanie</given-names>
        </name>
        <degrees>BS</degrees>
        <xref rid="aff1" ref-type="aff">1</xref>
      </contrib>
      <contrib contrib-type="author" id="contrib2">
        <name name-style="western">
          <surname>Prince</surname>
          <given-names>Patricia</given-names>
        </name>
        <degrees>MPH</degrees>
        <xref rid="aff1" ref-type="aff">1</xref>
        <ext-link ext-link-type="orcid">http://orcid.org/0000-0001-8537-1609</ext-link>
      </contrib>
      <contrib contrib-type="author" id="contrib3" corresp="yes">
      <name name-style="western">
        <surname>Jones</surname>
        <given-names>Clifford</given-names>
      </name>
      <degrees>BSE</degrees>
      <xref rid="aff1" ref-type="aff">1</xref>
      <address>
        <institution>AllazoHealth</institution>
        <addr-line/>
        <addr-line>New York, NY,</addr-line>
        <country>United States</country>
        <email>cliff@allazohealth.com</email>
      </address> </contrib>
      <contrib contrib-type="author" id="contrib4">
        <name name-style="western">
          <surname>Connor</surname>
          <given-names>Suzy</given-names>
        </name>
        <degrees>BCACP, PharmD</degrees>
        <xref rid="aff2" ref-type="aff">2</xref>
      </contrib>
      <contrib contrib-type="author" id="contrib5">
        <name name-style="western">
          <surname>Greene</surname>
          <given-names>Estay</given-names>
        </name>
        <degrees>PharmD</degrees>
        <xref rid="aff2" ref-type="aff">2</xref>
      </contrib>
    </contrib-group>
    <aff id="aff1">
      <sup>1</sup>
      <institution>AllazoHealth</institution>
      <addr-line>New York, NY</addr-line>
      <country>United States</country>
    </aff>
    <aff id="aff2">
      <sup>2</sup>
      <institution>Blue Cross and Blue Shield of North Carolina</institution>
      <addr-line>Durham, NC</addr-line>
      <country>United States</country>
    </aff>
    <author-notes>
      <corresp>Corresponding Author: Clifford Jones 
      <email>cliff@allazohealth.com</email></corresp>
    </author-notes>
    <pub-date pub-type="collection"><season>Jan-Dec</season><year>2017</year></pub-date>
    <pub-date pub-type="epub">
      <day>22</day>
      <month>09</month>
      <year>2017</year>
    </pub-date>
    <volume>3</volume>
    <issue>1</issue>
    <elocation-id>e13</elocation-id>
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    <history>
      <date date-type="received">
        <day>12</day>
        <month>7</month>
        <year>2017</year>
      </date>
      <date date-type="accepted">
        <day>25</day>
        <month>8</month>
        <year>2017</year>
      </date>
    </history>
    <!--(c) the authors - correct author names and publication date here if necessary. Date in form ', dd.mm.yyyy' after jmir.org-->
    <copyright-statement>©Brittanie Gracey, Patricia Prince, Clifford Jones, Suzy Connor, Estay Greene. Originally published in Iproceedings (http://www.iproc.org), 22.09.2017.</copyright-statement>
    <copyright-year>2017</copyright-year>
    <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/">
      <p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in Iproceedings, is properly cited. The complete bibliographic information, a link to the original publication on http://www.iproc.org/, as well as this copyright and license information must be included.</p>
    </license>  
    <self-uri xlink:href="http://www.iproc.org/2017/1/e13/" xlink:type="simple"/>
    <abstract>
      <sec sec-type="background">
        <title>Background</title>
        <p>AllazoHealth utilizes predictive analytics to improve medication adherence by targeting patients whose behavior can be changed with intervention programs. The AllazoEngine utilizes Rx claims, previous intervention data, and demographics to predict future adherence, to prioritize the patients whose behaviors can be changed, and to select the intervention channel and messaging most effective for each individual patient. Blue Cross and Blue Shield of North Carolina commissioned AllazoHealth’s predictive analytics and separately commissioned medication intervention delivery services for this adherence program.</p>
      </sec>
      <sec sec-type="objective">
        <title>Objective</title>
        <p>This study aimed to evaluate the effectiveness of the AllazoEngine and targeted interventions to improve medication adherence.</p>
      </sec>
      <sec sec-type="methods">
        <title>Methods</title>
        <p>This was a double-blind, randomized controlled trial (RCT) focused on RAS antagonists, oral anti-diabetics, and Statins. Patients were randomized to receive no intervention, traditional non-Allazo-targeted interventions, or interventions targeted by the AllazoEngine. All interventions consisted of live calls, direct mail to patients, and faxes to prescribers. Patients were defined as adherent in accordance with Medicare Star ratings methodology if their proportion of days covered (PDC) was greater than 80%. Patients’ adherence status in 2015 was compared to their adherence status in 2016 after the intervention period. Difference-in-Differences (DiD) analysis was used to compare the effect of each intervention method. Statistical significance was set to 10%.</p>
      </sec>
      <sec sec-type="results">
        <title>Results</title>
        <p>The primary study population consisted of 14,377 controls, 5,423 traditional non-Allazo targeted-intervention patients and 24,527 Allazo targeted intervention patients. Patients had comparable characteristics at baseline and comparable decrease in medication adherence in the pre-intervention observation period across the intervention groups. Non-Allazo-targeted interventions did not statistically improve the likelihood of adherence. Patients who received Allazo-targeted interventions performed statistically better than both the non-Allazo targeted group and control group (<italic>P</italic>=.06 and .03). Assuming net positive uplift from non-Allazo interventions, Allazo interventions accounted for 7.7 times the per-patient uplift in adherence compared to non-Allazo interventions.</p>
      </sec>
      <sec sec-type="conclusions">
        <title>Conclusions</title>
        <p>Due to the specific study design of not including new patients, adherence decreased in each intervention group over the intervention period. However, the decrease was significantly less for those in the Allazo group compared to both the non-Allazo and control groups.</p>
      </sec>
    </abstract>
    <kwd-group>
      <kwd>diabetes</kwd>
      <kwd>medication adherence</kwd>
      <kwd>star-ratings</kwd>
      <kwd>hypertension</kwd>
      <kwd>predictive analytics</kwd>
    </kwd-group></article-meta>
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