RESUMO
OBJECTIVE: This study aimed to determine the impact of an adherence intervention program on medication adherence rates and performance on the Centers for Medicare and Medicaid Services star ratings measures. SETTING: The study was conducted in a large community pharmacy chain comprising more than 2200 pharmacies and 7000 pharmacists across 36 states. PRACTICE DESCRIPTION: Pharmacists conducted adherence interventions with patients with a proportion of days covered (PDC) of less than 80% for hypertension, cholesterol, and diabetes star ratings medications. PRACTICE INNOVATION: A longitudinal, pharmacist-led adherence intervention program with automated follow-up interventions was implemented between June 2017 and December 2017. EVALUATION: The percentage of patients with a PDC of greater than or equal to 80% and performance on CMS star ratings measures were evaluated for Medicare Part D Prescription Drug Plan (PDP) and Medicare Advantage Prescription Drug (MAPD) Plan populations in 2017 compared with that of 2015 and 2016. Patient-level PDC change, pharmacist intervention completion, and pharmacist recommendation of additional pharmacy services were also measured. RESULTS: A total of 241,261 interventions were generated in the electronic dispensing systems. Pharmacists enrolled 60,232 patients and completed 75.4% of follow-up interventions, with an average of 1.3 follow-ups per patient. For the Medicare PDP population, improvement in the percentage of adherent patients ranged from 1.1% to 1.2% and 0.9% to 1.8% for 2015-2016 and 2016-2017, respectively, whereas improvement ranged from 2.1% to 2.5% and 2.0% to 3.0% for 2015-2016 and 2016-2017, respectively, for the MAPD Plan population. In 2016 and 2017, performance on cholesterol and diabetes measures achieved the 4-star cut point, and the hypertension measure achieved the 5-star cut point. CONCLUSION: This study demonstrated the successful implementation and pharmacist participation in an adherence intervention program in a large community pharmacy chain. Compared with the previous year, medication adherence improved for patients attributed to hypertension, cholesterol, and diabetes measures, and performance on CMS star rating measures was maintained, despite an increase in cut points.