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The implications of therapeutic complexity on adherence to cardiovascular medications

Niteesh K Choudhry1, Michael A Fischer, Jerry Avorn

  • 1Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02120, USA. nchoudhry@partners.org

Archives of Internal Medicine
|May 11, 2011
PubMed

Insights

Medication regimen complexity in cardiovascular disease patients is linked to lower adherence. Simplifying prescription filling and reducing pharmacy visits may improve patient adherence to medications.

Area of Science:

  • Cardiovascular disease pharmacotherapy
  • Medication adherence research
  • Health services research

Background:

  • Chronic disease patients often manage complex medication regimens, increasing the risk of nonadherence.
  • Factors like multiple daily doses and frequent pharmacy visits contribute to medication nonadherence.
  • Understanding prescribing and filling complexity is crucial for improving adherence in cardiovascular patients.

Purpose of the Study:

  • To quantify the complexity of prescribing and prescription filling for cardiovascular medications.
  • To assess the association between medication regimen complexity and patient adherence.

Main Methods:

  • A large cohort study analyzed individuals prescribed statins or ACEI/ARBs between 2006-2007.
  • Complexity was measured by the number of medications, prescribers, pharmacies, pharmacy visits, and refill consolidation over 3 months.
  • Adherence was evaluated over the subsequent year using multivariable linear regression.

Main Results:

  • Cardiovascular patients, on average, filled over 11 prescriptions for 6 medications, saw 2 prescribers, and made 5 pharmacy visits in 3 months.
  • Increased prescribing and filling complexity was significantly associated with lower medication adherence.
  • Patients with the least refill consolidation showed 8% lower adherence over one year.

Conclusions:

  • Medication use and prescription filling processes for cardiovascular disease patients are highly complex.
  • Strategies aimed at simplifying medication regimens and pharmacy interactions may enhance patient adherence.
Abstract

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