Pharmacy, Health Sciences & Exercise Science
Event Title
Medication Adherence of Patients with Asthma and Chronic Obstructive Pulmonary Disease (COPD) at Butler University, A Self Insured Employer
Document Type
Oral Presentation
Location
Indianapolis, IN
Subject Area
Pharmacy, Health Sciences & Exercise Science
Start Date
10-4-2015 11:45 AM
End Date
10-4-2015 12:00 PM
Sponsor
Jason Range, Carrie Maffeo (Butler University)
Description
Purpose: Previous research shows that adherence to asthma/COPD medications is poor; estimates range from 20-40%. Traditionally, good adherence is defined as greater than 80%, which is associated with decreased hospitalizations and health care costs. This study will identify the adherence rate in asthma/COPD patients compared to benchmark rates, and propose pharmacist led programs to improve adherence and decrease costs for a self-insured employer.
Methods: This retrospective, longitudinal study used existing de-identified pharmacy claims data for a 12-month period from Butler University, a self-insured employer. Inclusion criteria included: being an employee or dependent of an employee of Butler University, and having two or more fills of a medication for daily, continuous use for the identified condition. Adherence rates for patients with asthma/COPD were calculated using the Proportion of Days Covered (PDC) method. Independent sample t-tests, one-way ANOVA tests, and simple linear regression models were run to identify any relationships between independent variables (age, gender, pharmacy source, employee status, new prescriptions, medication classes, and age) and adherence rates. A logistic regression model was created to identify predictors of adherence.
Results: Eighty-two (n=82) patients were included in this analysis. The mean adherence rate of all patients was 70.4%, significantly less than the benchmark of 80% (p=0.001). Thirty-six patients (43.9%) were found to be adherent with a PDC greater than 80%. Patients taking oral medications were more likely to have adherence rates greater than 80% than those using inhaled medications (p=0.008), however there were no significant differences found between classes of inhaled medications. Men were found to have higher adherence rates than women (p=0.018). Age was not correlated with adherence rates in the population as a whole or in women, however men over 60 years old had higher adherence rates than men between 15 and 35 years old (p=0.031). Prescriptions filled at a mail-order pharmacy were associated with higher adherence rates than those filled at a retail pharmacy (p=0.004). University employees were also found to have significantly higher adherence rates than non-employees (p=0.043). A logistic regression model to predict adherence greater than 80% was created including gender, age, pharmacy source, employee status, route of administration, and new prescriptions (p=0.009).
Conclusions: Although the adherence rates found in this study are higher than previous literature, there is still much room for improvement in this population. This study identified both patient and medication related variables as indicators of adherence. These findings will be used to help identify target populations while developing pharmacist-led programs aimed at improving adherence of asthma/COPD medications.
Medication Adherence of Patients with Asthma and Chronic Obstructive Pulmonary Disease (COPD) at Butler University, A Self Insured Employer
Indianapolis, IN
Purpose: Previous research shows that adherence to asthma/COPD medications is poor; estimates range from 20-40%. Traditionally, good adherence is defined as greater than 80%, which is associated with decreased hospitalizations and health care costs. This study will identify the adherence rate in asthma/COPD patients compared to benchmark rates, and propose pharmacist led programs to improve adherence and decrease costs for a self-insured employer.
Methods: This retrospective, longitudinal study used existing de-identified pharmacy claims data for a 12-month period from Butler University, a self-insured employer. Inclusion criteria included: being an employee or dependent of an employee of Butler University, and having two or more fills of a medication for daily, continuous use for the identified condition. Adherence rates for patients with asthma/COPD were calculated using the Proportion of Days Covered (PDC) method. Independent sample t-tests, one-way ANOVA tests, and simple linear regression models were run to identify any relationships between independent variables (age, gender, pharmacy source, employee status, new prescriptions, medication classes, and age) and adherence rates. A logistic regression model was created to identify predictors of adherence.
Results: Eighty-two (n=82) patients were included in this analysis. The mean adherence rate of all patients was 70.4%, significantly less than the benchmark of 80% (p=0.001). Thirty-six patients (43.9%) were found to be adherent with a PDC greater than 80%. Patients taking oral medications were more likely to have adherence rates greater than 80% than those using inhaled medications (p=0.008), however there were no significant differences found between classes of inhaled medications. Men were found to have higher adherence rates than women (p=0.018). Age was not correlated with adherence rates in the population as a whole or in women, however men over 60 years old had higher adherence rates than men between 15 and 35 years old (p=0.031). Prescriptions filled at a mail-order pharmacy were associated with higher adherence rates than those filled at a retail pharmacy (p=0.004). University employees were also found to have significantly higher adherence rates than non-employees (p=0.043). A logistic regression model to predict adherence greater than 80% was created including gender, age, pharmacy source, employee status, route of administration, and new prescriptions (p=0.009).
Conclusions: Although the adherence rates found in this study are higher than previous literature, there is still much room for improvement in this population. This study identified both patient and medication related variables as indicators of adherence. These findings will be used to help identify target populations while developing pharmacist-led programs aimed at improving adherence of asthma/COPD medications.