The effect of a medication safety reminder letter for high-risk patients under a universal health insurance scheme- A pilot study.

Objectives: Nudge interventions have been applied to change patients' health behavior in the areas of smoking cessation and healthy food choices. Patient activation is one of the key elements in the self-management of health. This study explored whether a medication safety reminder for high-risk patients can prompt doctors to reconcile patients' prescriptions and examine the role of patient activation. Study design: This was a cross-sectional study. Methods: This study selected eleven thousand subjects from the list of patients with duplicated medication in 2019 provided by the Taiwanese single-payer insurance scheme. Postal reminder letters were sent to the patients. After a month, questionnaires were sent out to ask patients whether they had consulted their doctors after receiving the medication reminder letter, and the doctors checked or revised their prescriptions. A total of 841 completed questionnaires were received, and 34.8 % of them had asked their doctors to check the prescription. Results: The results from regression models revealed that patients with higher patient activation had a higher rate (odds ratio [OR] = 2.617) of asking their doctor to check the prescription (p < 0.001) compared with those with lower patient activation. Conclusions: The present study shows that nudging intervention by the health insurer to the patients can prompt individuals to request healthcare providers to check their prescriptions. This may reduce healthcare resource waste and increase care safety.