One last study examined the relative effectiveness of ADM enhancement strategies. Stuart, laraia, Ornstein, and Nietert (2003) compared the effectiveness of three approaches to enhance adherence. They experimented with an interactive voice response (IVR) system to enhance ADM adherence using PCP nurses who provided educational materials and follow-up telephone calls in two of the three approaches. Three strategies were tested for their relative effectiveness in enhancing adherence: (a) education alone; (b) education and telephone calls; or (c) education, calls, and IVR. No significant differences in adherence outcomes were noted across the different treatment strategies. Patients’ anecdotal comments suggested that they would prefer to receive rather than make calls to the automated IVR system and they would prefer to speak to a live person.