This recommendation should not be interpreted to mean that interventions aimed at improving anticoagulant adherence are not important. Successful strategies used to improve medication adherence in other chronic disease states have included (1) ensuring access to providers across the continuum of care and implementing team- based care (see recommendation 11); (2) educating and empower- ing patients to understand the treatment regimen and its benefits (see recommendation 12); (3) reducing barriers to obtaining medication, including cost reduction and efforts to retain or reengage patients in care; and (4) use of health information technology tools to improve decision-making and communication during and after office visits (see recommendations 3 and 4).165 The panel identified the following additional research priority: develop- ment and testing of adherence interventions that are acceptable, feasible, and affordable, especially for patients on DOAC or on VKA and not considered eligible for PST or PSM, and determining the impact of those interventions on clinical outcomes and cost-effectiveness. For patients receiving anticoagulation therapy for treatment of VTE, the ASH guideline panel suggests against using elec- tronic reminders (daily alarm via an electronic medication monitoring system) to improve medication adherence (condi- tional recommendation based on very low certainty in the evi- dence about effects ). Remark: This recommendation applies specifically to a sophisticated alert system used in the study evaluated by the panel. Summary of the evidence. One RCT reported the effect of an electronic medication monitoring system with a daily alarm to remind patients to take their anticoagulant medication as sched- The main outcome was anticoagulation control, as measured by out-of-range INRs, and secondary outcomes included mortality, bleeding, and thromboembolic events. The EtD framework is shown online at https://dbep.gradepro.org/profile/92492887-D3C0-CAC2- BEEE-D88978A91C30. Benefits. For benefits, see the evidence profile in the EtD framework referenced at the end of the previous section, available online. 