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Using aggregated pharmacy claims to identify primary nonadherence.

Dominique Comer, Joseph Couto, Ruth Aguiar

  • 1Christiana Care Health System, 4755 Ogletown-Stanton Rd, Newark, DE 19718.

The American Journal of Managed Care
|January 14, 2016
PubMed
Summary
This summary is machine-generated.

Electronic health records (EHR) reveal that 66% of patients filled their new antihypertensive prescriptions within 30 days. Lower diastolic blood pressure and Medicare coverage were linked to increased nonadherence to this essential therapy.

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Area of Science:

  • Health Informatics
  • Pharmacology
  • Public Health

Background:

  • Electronic health records (EHR) integrate pharmacy claims, offering real-time insights into medication adherence.
  • Primary nonadherence, the failure to fill an initial prescription, impacts therapeutic outcomes.
  • Understanding nonadherence is crucial for improving patient management in primary care.

Purpose of the Study:

  • To determine the prevalence and predictors of primary nonadherence to antihypertensive medications.
  • To leverage pharmacy claims data within an EHR for real-time adherence monitoring.
  • To identify patient characteristics associated with nonadherence in a multi-payer primary care network.

Main Methods:

  • Retrospective cohort study of patients prescribed new antihypertensive drugs (January 2011 - September 2012).
  • Matching new antihypertensive prescriptions with pharmacy claims data in the EHR.
  • Defining primary nonadherence as the absence of a medication fill within 30 days of prescription.

Main Results:

  • Out of 791 patients, 66% (522) filled their antihypertensive prescription within 30 days.
  • Of those who filled, 78.4% (409) did so on the same day the prescription was issued.
  • Lower diastolic blood pressure and Medicare insurance coverage were associated with a higher likelihood of primary nonadherence.

Conclusions:

  • Provider EHR medication fill data can effectively identify primary nonadherence in clinical settings.
  • Increasing adoption of this technology facilitates the identification of nonadherence.
  • This capability enables the development of targeted interventions to enhance medication adherence and improve therapeutic effectiveness.