Medication Nonadherence Among Medicare Beneficiaries with Comorbid Chronic Conditions: Influence of Pharmacy Dispensing Channel

Iyengar, Reethi; Lefrancois, Abbey; Henderson, Rochelle; Rabbitt, Rebecca M.

doi:10.18553/jmcp.2016.22.5.550

Cited by 16 publications

(16 citation statements)

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“…According to our analyses of pharmacy characteristics, the provision of accommodations that may improve access to prescription medications has not changed and the vast majority of pharmacies do not offer them. For example, only one-fourth of pharmacies offered home delivery, despite a growing population of homebound elderly [ 25 ], as well as some evidence that home delivery improves medication adherence [ 9 ]. The availability of 24-hour pharmacies is also of interest; since only one in twenty pharmacies we examined are opened for 24-hours, yet longer hours of operation may be associated with lower hospital re-admissions [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies suggest that many patients encounter barriers in accessing prescription medications associated with the availability, and characteristics of, their local pharmacies. For example, inadequate pharmacy accessibility[ 7 , 8 ] or the lack of accommodations, such as home delivery [ 9 ] and e-prescribing [ 10 ], are associated with higher rates of non-adherence to prescription medications in some communities. There is also some evidence that language concordance between patients and providers, and the provision of multilingual staff or interpreter services at local pharmacies, reduce non-adherence, including primary non-adherence, in non-English speaking patients [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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The availability of pharmacies in the United States: 2007–2015

et al. 2017

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ImportanceDespite their increasingly important role in health care delivery, little is known about the availability, and characteristics, of community pharmacies in the United States.Objectives(1) To examine trends in the availability of community pharmacies and pharmacy characteristics (24-hour, drive-up, home delivery, e-prescribing, and multilingual staffing) associated with access to prescription medications in the U.S. between 2007 and 2015; and (2) to determine whether and how these patterns varied by pharmacy type (retail chains, independents, mass retailers, food stores, government and clinic-based) and across counties.MethodsRetrospective analysis using annual data from the National Council for Prescription Drug Programs. Pharmacy locations were mapped and linked to the several publically-available data to derive information on county-level population demographics, including annual estimates of total population, percent of population that is non-English speaking, percent with an ambulatory disability and percent aged ≥65 years. The key outcomes were availability of pharmacies (total number and per-capita) and pharmacy characteristics overall, by pharmacy type, and across counties.ResultsThe number of community pharmacies increased by 6.3% from 63,752 (2007) to 67,753 (2015). Retail chain and independent pharmacies persistently accounted for 40% and 35% of all pharmacies, respectively, while the remainder were comprised of mass retailer (12%), food store, (10%), clinic-based (3%) or government (<1%) pharmacies. With the exception of e-prescribing, there was no substantial change in pharmacy characteristics over time. While the number of pharmacies per 10,000 people (2.11) did not change between 2007 and 2015 at the national-level, it varied substantially across counties ranging from 0 to 13.6 per-capita in 2015. We also found that the majority of pharmacies do not offer accommodations that facilitate access to prescription medications, including home-delivery, with considerable variation by pharmacy type and across counties. For example, the provision of home-delivery services ranged from less than <1% of mass retailers to 67% of independent stores and was not associated with county demographics, including ambulatory disability population and percent of the population aged ≥65 years.ConclusionsDespite modest growth of pharmacies in the U.S., the availability of pharmacies, and pharmacy characteristics associated with access to prescription medications, vary substantially across local areas. Policy efforts aimed at improving access to prescription medications should ensure the availability of pharmacies and their accommodations align with local population needs.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The availability of pharmacies in the United States: 2007–2015

et al. 2017

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“…Fifth, our definition of medication adherence assumes observed medication supply and/or prescription fills equate with actual medication‐taking behavior. While this definition may not be entirely accurate, use of PDC and administrative claims are well‐documented in the scientific literature . Lastly, our analytic models did not account for the effect of the coverage gap on predicting adherence.…”

Section: Discussionmentioning

confidence: 99%

“…While this definition may not be entirely accurate, use of PDC and administrative claims are well-documented in the scientific literature. 43,44,51 Lastly, our analytic models did not account for the effect of the coverage gap on predicting adherence. Due to increased cost-sharing, patients who reached the coverage gap, within 1-year following index admission, may have discontinued treatment.…”

Section: Discussionmentioning

confidence: 99%

Novel application of approaches to predicting medication adherence using medical claims data

Zullig

Jazowski

Wang

et al. 2019

Health Services Research

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Objective To compare predictive analytic approaches to characterize medication nonadherence and determine under which circumstances each method may be best applied. Data Sources/Study Setting Medicare Parts A, B, and D claims from 2007 to 2013. Study Design We evaluated three statistical techniques to predict statin adherence (proportion of days covered [PDC ≥ 80 percent]) in the year following discharge: standard logistic regression with backward selection of covariates, least absolute shrinkage and selection operator (LASSO), and random forest. We used the C‐index to assess model discrimination and decile plots comparing predicted values to observed event rates to evaluate model performance. Data Extraction We identified 11 969 beneficiaries with an acute myocardial infarction (MI)‐related admission from 2007 to 2012, who filled a statin prescription at, or shortly after, discharge. Principal Findings In all models, prior statin use was the most important predictor of future adherence (OR = 3.65, 95% CI: 3.34‐3.98; OR = 3.55). Although the LASSO regression model selected nearly 90 percent of all candidate predictors, all three analytic approaches had moderate discrimination (C‐index ranging from 0.664 to 0.673). Conclusions Although none of the models emerged as clearly superior, predictive analytics could proactively determine which patients are at risk of nonadherence, thus allowing for timely engagement in adherence‐improving interventions.

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“…Результаты показали, что доставка пре-паратов на дом положительно сказывается на компла-енсе пациентов, и внедрение такого пути профилак-тики сердечно-сосудистых осложнений требует дальнейшего изучения с точки зрения экономических преимуществ впоследствии [21]. В штате Калифорния (США) было проведено исследование, которое пока-зало возможность использования мультиканальных напоминаний (письма-предписания) пациентам с АГ, сахарным диабетом и повышенным холестерином.…”

Section: материалы и методыunclassified

The Review of Modern Studys About the Importance of Compliance of Patients to Treatment of Сardiovascular Diseases

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2017

Klinicist

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Medication Nonadherence Among Medicare Beneficiaries with Comorbid Chronic Conditions: Influence of Pharmacy Dispensing Channel

Cited by 16 publications

References 24 publications

The availability of pharmacies in the United States: 2007–2015

The availability of pharmacies in the United States: 2007–2015

Novel application of approaches to predicting medication adherence using medical claims data

The Review of Modern Studys About the Importance of Compliance of Patients to Treatment of Сardiovascular Diseases

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