A Multichannel Medication Adherence Intervention Influences Patient and Prescriber Behavior

Area of Science:

• Health Services Research
• Pharmaceutical Policy
• Quality Improvement

Background:

• Medicare Advantage prescription drug (MA-PD) plans utilize medication adherence measures, impacting Part D and overall star ratings.
• MA-PD plans are increasingly implementing adherence interventions to boost performance, but evaluations are limited.

Purpose of the Study:

• To evaluate a multichannel adherence intervention's impact on medication adherence and quality performance in two MA-PD plans.
• The intervention combined prescriber-directed 90-day refills and member-directed refill reminders.

Main Methods:

• A quasi-experimental design compared intervention MA-PD plans with control plans using pharmacy claims and enrollment data.
• Adherence was measured by proportion of days covered (PDC); difference-in-difference (DID) estimators controlled for confounders.
• CMS star ratings for adherence measures (diabetes, hypertension, cholesterol) were compared pre- and post-intervention.

Main Results:

• The intervention significantly increased adherence for hypertension (2.0 pp) and cholesterol (1.8 pp) compared to controls.
• Odds of achieving 80% adherence increased for hypertension (ROR=1.334) and cholesterol (ROR=1.247).
• CMS adherence rates for diabetes, hypertension, and cholesterol increased more in intervention plans than control plans.

Conclusions:

• A combined prescriber and patient-directed intervention improved adherence to hypertension and cholesterol medications.
• Multichannel interventions can effectively address adherence barriers and enhance MA-PD quality performance ratings.