Disagreement between pharmacy claims and direct interview to identify patients with non-adherence to chronic cardiometabolic medications.
Am Heart J
; 256: 51-59, 2023 02.
Article
em En
| MEDLINE
| ID: mdl-36780373
ABSTRACT
BACKGROUND:
Accurate methods of identifying patients with suboptimal adherence to cardiometabolic medications are needed, and each approach has benefits and tradeoffs.METHODS:
We used data from a large trial of patients with poorly controlled cardiometabolic disease and evidence of medication non-adherence measured using pharmacy claims data whose adherence was subsequently assessed during a telephone consultation with a clinical pharmacist. We then evaluated if the pharmacist assessment agreed with the non-adherence measured using claims. When pharmacist and claims assessments disagreed, we identified reasons why claims were insufficient and used multivariable modified Poisson regression to identify patient characteristics associated with disagreement.RESULTS:
Of 1,069 patients identified as non-adherent using claims (proportion of days covered [PDC] <80%), 646 (60.4%) were confirmed as non-adherent on pharmacist interview. For the 423 patients (39.6%) where the interview disagreed with the claims, the most common reasons were paying cash or using an alternate insurance (36.6%), medication discontinuation or regimen change (32.8%), and recently becoming adherent (26.7%). Compared to patients whose claims and interview both showed non-adherence, patients whose interview disagreed with claims were less likely to miss outpatient office visits (RR0.91, 95%CI0.85-0.97) and more likely to have a baseline PDC above the median (RR1.35, 95%CI1.10-1.64).CONCLUSIONS:
Among patients identified as non-adherent by claims, 39.6% were observed to be adherent when assessed during pharmacist consultation. This discrepancy was largely driven by paying out-of-pocket, using alternative insurance, or medication discontinuation or change. These findings have important implications for using pharmacy claims to identify and intervene upon medication non-adherence.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Farmácia
/
Doenças Cardiovasculares
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article