Structures and Processes Associated with Integrating Pharmacy Claims Data into Antiretroviral Adherence Support...

A multidisciplinary collaboration is needed to improve antiretroviral (ARV) therapy adherence among people with HIV (PWH) to ensure adequate patient outcomes. The AdhereP4 program was a collaboration among pharmacies, prescribers, payers, and public health agencies that identified PWH with a ≥30-day gap in ARV access using pharmacy claims data. While pharmacy claims data are useful for identifying adherence gaps, limited guidance exists on structures and processes needed to integrate such data in pharmacy and clinical services to better provide adherence support. The AdhereP4 program identified key programmatic structures and processes for a successful collaboration of pharmacy claims data with dispensing pharmacy and clinical patient data. Structures include staffing, data, and procedures while programmatic processes include adherence assessment, adherence intervention, and training/communication. AdhereP4 implementation required support from an information technologist, database managers, programmers, pharmacists, clinicians, social workers/case managers, and a public health specialist. Key lessons learned from the development and implementation of the AdhereP4 program were identified through monthly collaborator meetings and informal collaborator interviews. Lessons identified included (1) develop support and training for all collaborators; (2) develop a data dictionary for each site prior to data collection; (3) develop a standard operating procedure manual related to data management; and (4) complete periodic review of data to address any concerns early. Monthly pharmacy claims data can be successfully used by pharmacy and clinic staff to identify and address ARV adherence gaps. Successful implementation requires collaboration across stakeholders and a clear data management plan.