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Encouraging a "fresh start" mentality associated with occasions such as birthdays and New Year's Day was not enough to coax people into better medication adherence, a randomized study found.

In the study, , of Washington University in St. Louis, and colleagues reminded 13,323 participants (45% men) by email to take their medication. Patients were all under commercial or Medicare Advantage insurance with Humana and had 40% to 80% medication adherence during the prior 12 months.

On average, Dai's group reported online in , people filled prescriptions covering 63.3% of the 90 days following the email, with no differences related to the timing of the reminder:

• Random date not close to New Year's or birthday (control)
• Week before birthday
• Week before birthday, with explicit references to new beginnings associated with the occasion
• 3 weeks after New Year's Day
• 3 weeks after New Year's Day, with explicit references to new beginnings associated with the occasion

Dai and her colleagues randomized the timing of when patients receive the emails. Pharmacy claims provided data on the proportion of days covered for diabetes, cholesterol, or blood pressure pills.

"Contrary to our expectations, sending reminders following fresh-start dates was not associated with increased medication adherence, and fresh-start–based framing was not associated with increased reminder effectiveness," the researchers concluded.

But they weren't ready to give up on the idea.

"Reminders received immediately after the target date could be more effective," they wrote. "We encourage further study before concluding that the psychology of fresh starts does not apply to medication adherence."

Among the limitations of the study were the lack of a no-email group and the fact that Humana sent medication adherence reminders outside of the study, the authors noted.

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