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

**Authors:** Shou-Hsia Cheng, Yafang Tsai

PMC · DOI: 10.1016/j.puhip.2025.100684 · 2025-12-11

## TL;DR

A pilot study found that sending reminder letters to high-risk patients can encourage them to consult doctors about their medications, potentially improving safety and reducing waste.

## Contribution

This study introduces a novel nudge intervention by a health insurer to activate patients and improve medication safety.

## Key findings

- 34.8% of patients who received reminder letters consulted their doctors about their prescriptions.
- Higher patient activation significantly increased the likelihood of consulting a doctor (OR = 2.617).

## Abstract

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.

This was a cross-sectional study.

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.

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.

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.

## Full-text entities

- **Species:** Homo sapiens (human, species) [taxon 9606]

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Source: https://tomesphere.com/paper/PMC12775999