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Do medical homes increase medication adherence for persons with multiple chronic conditions?
Christopher A Beadles1, Joel F Farley, Alan R Ellis
1*RTI International Durham, NC †Department of Health Policy and Management, UNC Gillings School of Global Public Health ‡Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill §Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill ∥Community Care of North Carolina, Raleigh, NC.
Medical home enrollment significantly improves medication adherence for individuals with multiple chronic conditions (MCC). This study found higher adherence rates among those in medical homes compared to non-enrollees, enhancing chronic disease management.
Area of Science:
- Health Services Research
- Chronic Disease Management
- Medication Adherence
Background:
- Suboptimal medication adherence is a significant barrier to effective chronic condition management, particularly for individuals with multiple chronic conditions (MCC).
- Medical homes offer a potential framework to improve adherence and enhance care for patients with MCC.
Purpose of the Study:
- To investigate the association between enrollment in a medical home model and adherence to newly prescribed medications.
- Focus on Medicaid enrollees diagnosed with multiple chronic conditions.
Main Methods:
- Retrospective cohort study utilizing North Carolina Medicaid claims data (2008-2010).
- Compared medical home enrollees with non-enrollees.
- Analyzed adherence for new users of antidepressants, antihypertensives, oral diabetes agents, and statins using proportion of days covered (PDC).
Main Results:
- Medical home enrollees demonstrated significantly higher medication adherence across all studied conditions.
- Proportion of days covered (PDC) increased by 4.7-6.0 percentage points for medical home enrollees.
- Dichotomous adherence measures (PDC > 0.80) also showed statistically significant improvements.
Conclusions:
- Enrollment in a medical home is associated with greater adherence to newly initiated medications among Medicaid beneficiaries with multiple chronic conditions.
- Medical homes may play a crucial role in improving medication adherence and outcomes for complex patient populations.
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