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Assessing compliance to antihypertensive medications using computer-based pharmacy records
D B Christensen1, B Williams, H I Goldberg
1Department of Pharmacy and Health Services, University of Washington, Seattle 98195-7630, USA.
Medical Care
|November 21, 1997
Summary
Computer algorithms assessing prescription refill patterns can detect potential drug compliance issues in chronic disease management. However, these refill-based methods require cautious interpretation due to potential data discrepancies and do not confirm actual medication adherence.
Area of Science:
- Pharmacology
- Health Informatics
- Chronic Disease Management
Background:
- Optimizing prescribed drug therapy in chronic disease management necessitates systematic approaches for compliance problem detection and intervention.
- Computer algorithms analyzing prescription refill patterns offer an unobtrusive method for assessing medication adherence.
Purpose of the Study:
- To evaluate the utility and limitations of computer-generated algorithms based on refill patterns for detecting drug-taking compliance problems.
- To provide guidance for healthcare professionals, particularly pharmacists, in interpreting compliance data derived from refill patterns.
Main Methods:
- Analysis of computer algorithms that assess patient compliance based on prescription refill data.
- Examination of the advantages and disadvantages of refill-based compliance measures.
- Consideration of time periods for compliance assessment, with a recommendation for caution with intervals less than 60 days.
Main Results:
- Refill pattern algorithms measure refill timeliness, not actual drug ingestion, presenting a potential limitation.
- These algorithms can flag potential compliance issues but may also indicate discrepancies in medical charts, pharmacy records, or patient communication.
- Calculating compliance rates across multiple refills and using longer time periods (e.g., >60 days) can decrease false positives but may reduce the number of assessable patients.
Conclusions:
- Healthcare professionals should exercise caution when using computer-generated compliance flags based on refill patterns.
- Before initiating interventions for non-compliance, it is crucial to investigate potential discrepancies in drug records.
- Refill pattern analysis is a useful tool but requires careful interpretation and validation with other data sources for accurate patient care.
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