Medication Refill Adherence in Patients with Chronic Inflammatory Eye Disease

To utilize pharmacy dispenses to investigate adherence rates to immunosuppressive therapy (IMT) for the treatment of noninfectious inflammatory eye disease (IED), impact of adherence on disease control, factors associated with nonadherence, and association between adherence in the medical record and pharmacy dispenses.

Retrospective medical chart review was conducted on patients followed for at least 2 years in the uveitis clinic. Appointment and lab attendance, and provider documentation, determined adherence through the medical record. Dispense history was obtained from pharmacies, and IMT infusion dates were noted. Disease control was determined by clinical exam findings.

Sixty-three patients qualified for the study. The mean age was 49 years (SD = 19.4), 76.2% were female, 36.5% were Black/African American, and 96.8% were taking 1 or 2 IMTs. Pharmacy refill data was collected from 58 patients to determine an adherence rate (AR) of 63.9%. Thirty-nine patients (67.2%) had an average AR < 85% by pharmacy refill data and were thus deemed nonadherent. The majority of patients (86.2%) achieved ocular inflammation control. Nonadherence was 4.72 times more likely in patients taking >1 medication compared to one medication alone (95% CI: 1.02-21.86, p = 0.047). Comparing adherence from information in the medical record to pharmacy refill data, 71.6% of IMT comparisons were congruent (p < 0.0001).

Patients taking IMT for >2 years demonstrated an AR < 65% based on pharmacy data. Most patients achieved ocular quiescence. Using pharmacy information as an objective measure of adherence correlates with assessing adherence through medical record information.