Medicine possession ratio as proxy for adherence to antiepileptic drugs: prevalence, associations, and cost implications

Jacobs, Karen; Julyan, Marlene; Lubbe, Martie S.; Burger, Johanita; Cockeran, Marike

doi:10.2147/ppa.s98940

Cited by 7 publications

(6 citation statements)

References 59 publications

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“…Medication adherence was measured by the medication possession ratio (MPR), which is often used to indirectly measure medication adherence using administrative claims data. [ 21 , 28 ] The MPR was calculated as follows:

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Section: Methodsmentioning

confidence: 99%

Antidepressant adherence and its predictors in immigrants with depression

2020

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Immigrants in Korea are relatively vulnerable in terms of medication self-management and have low levels of medication adherence. We aimed to evaluate antidepressant adherence and its patterns in immigrants and to identify predictors of nonadherence. In this matched cohort study using the National Health Insurance claims database, immigrants who were newly prescribed antidepressants were identified (n = 2,398). The immigrants were matched with native-born Koreans in a 1:1 ratio. Antidepressant adherence was measured by the medication possession ratio at monthly intervals. Logistic regression was performed to compare antidepressant nonadherence between immigrants and native-born Koreans, and to identify factors affecting immigrants’ nonadherence. The average medication possession ratio of immigrants was 27.1%, which was lower than that of native-born Koreans (30.9%) ( P = .038). Immigrants had a lower likelihood of adherence than native-born Koreans (odds ratio [OR] 0.76, 95% confidence interval [CI] 0.3–0.92). Older age, visiting a psychiatrist for the first diagnosis of depression (OR 2.24, 95% CI 1.60–3.13), achieving appropriateness of care (OR 3.54, 95% CI 2.51–4.98), and having a usual source of care (OR 1.69, 95% CI 1.25–2.27) were associated with a higher likelihood of adherence in immigrants. This study showed that antidepressant adherence of immigrants was lower than that of native-born Koreans. However, it appears that visiting a psychiatrist, achieving appropriateness of care, and having a usual source of care might increase antidepressant adherence among immigrants. Further research that focuses on cultural and/or linguistic factors affecting immigrants’ adherence and healthcare utilization is suggested as a way to increase adherence.

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…”

Section: Methodsmentioning

confidence: 99%

Antidepressant adherence and its predictors in immigrants with depression

2020

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“…This reduces the benefit that could be gained from the medication. 5 A recent review of methods to improve adherence to anti-epileptic prescriptions suggests three fundamental sorts of interventions as educational, behavioural, and mixed interventions. 6 The supposition for educational mediation is that patients who comprehend their ailment and its treatment will be increasingly educated, have more control, and be bound to hold fast to treatment.…”

Section: Introductionmentioning

confidence: 99%

Impact of clinical pharmacist managed patient counselling on the knowledge and adherence to antiepileptic drug therapy

Chandrasekhar¹,

Mohanlal²,

Mathew³

et al. 2020

Clinical Epidemiology and Global Health

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To evaluate the medication adherence behaviour and knowledge of epilepsy patients before patient counselling and to monitor and evaluate the outcome of clnical pharmacist mediated patient counselling. Methodology: A prospective interventional study with one-year duration was conducted among 100 epileptic inpatients of the neurology department in a south Indian tertiary care hospital. Clinical pharmacy students mediated education was provided to the patients and bystanders, and its effect on medication adherence and patient beliefs was assessed through medication adherence scale (MMAS-4) and an internally validated beliefs about medication survey form. Results: Before the intervention, 40% of patients showed high adherence to antiepileptic drug (AED) therapy followed by 27% patients with a medium level of adherence and 33% of patients exhibited a low level of adherence. After the intervention, 62% of patients showed high adherence followed by 20% of patients with medium adherence and the remaining 18% exhibited a low level of adherence to AED therapy. Medication belief assessment after intervention also showed improving trends (P ≤ 0.05). The study defined that the overall improvement in medication adherence and knowledge of patients was found to be statistically significant after the intervention. Conclusion: The study concluded that low adherence to the medications and lack of knowledge about the disease was the major reasons for the unsuccessful drug treatment which can be cleared up to a satisfying extent by the use of clinical pharmacist intervention.

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“…This method measures adherence of patients by calculating the number of days of medication provided over the follow-up period where the follow-up period is fixed period (99,100) . The deviation of denominator causes MPR complicated to perform an evaluation on a large-scale population.…”

Section: Medication Possession Ratio (Mpr)mentioning

confidence: 99%

“…On account of pharmacy claims database, patients adhere to medications about 80% of the period is correlated with enhanced control of hypercholesterolemia (132) , diabetes mellitus (133) , and cut down mortality rate in patients with heart disease (132,133) . Accordingly, this cut-off point has widely been classified as adherent in many research (46,73,99,100) . Thus, the MPR was acknowledged agreeable if the computed value is ≥ 0.8 while a calculated MPR below than 0.8 demonstrates as undersupply of medication and was considered nonadherence to medication (17,99,134) .…”

Section: Figure 5 Patient Tracking Of Prescription Refill Pattern In ...mentioning

confidence: 99%

“…Accordingly, this cut-off point has widely been classified as adherent in many research (46,73,99,100) . Thus, the MPR was acknowledged agreeable if the computed value is ≥ 0.8 while a calculated MPR below than 0.8 demonstrates as undersupply of medication and was considered nonadherence to medication (17,99,134) . Whereas the value of MPR larger than 1.2 was truncated to 1.2 (124) .…”

Section: Figure 5 Patient Tracking Of Prescription Refill Pattern In ...mentioning

confidence: 99%

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Impact of maximum prescription length supply policy on patient medication adherence, health and economic outcomes

Jarujumrus¹

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In February 2016, Phramongkutklao hospital has implemented Extended Dispensing Policy (EDP), which increasing prescription length from 30-day to 90-day, with the purpose to increase adherence of patient to their medication prescribed. The objectives of this study were to determine the effects of the increasing in maximum prescription refill length from 30-day to 90-day on medication adherence, clinical outcomes such as HbA1c level and cholesterol level, economic outcomes including total healthcare costs, hospitalization costs, and total medication costs among diabetes and dyslipidemia patients in the Phramongkutklao hospital. This study is a quasi-experiment, pre-post, using a retrospective database from a hospital between 2014 to 2017. A difference-in-difference method with propensity score matching was applied to examine the change in medication adherence before and after the EDP implemented among the Universal Coverage insured patients. Multiple logistic and linear regression was performed to determine the association between predictors and interesting outcomes. For DM patients, the DID of MPR enhanced by 5% (P < 0.001). Likewise, the DID of dyslipidemia patients showed a significant increase of 4% (P < 0.001). In addition, the difference-in-difference of HbA1c in the intervention group over control group was lessened by 0.08% while reduction in cholesterol level by 2.83 mg/dL statistically significant (p < 0.001). Moreover, the results from regression revealed that for each 10% improvement in medication adherence was related with the significant reduction in HbA1c by 0.015% (p < 0.001), and cholesterol level by 1 mg/dl (p = 0.001). Furthermore, results from economic outcomes indicates that despite higher total medication costs, patients with greater medication adherence contributes significant saving due to reductions in time costs and hospitalization costs. There are several factors that affect medication adherence, particularly prescription length. Increasing prescription length from 30-day to 90-day, improved medication adherence, reduced in cholesterol and HbA1c level, and minimize total healthcare costs in dyslipidemia and type-2 diabetes patients.

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Medicine possession ratio as proxy for adherence to antiepileptic drugs: prevalence, associations, and cost implications

Cited by 7 publications

References 59 publications

Antidepressant adherence and its predictors in immigrants with depression

Antidepressant adherence and its predictors in immigrants with depression

Impact of clinical pharmacist managed patient counselling on the knowledge and adherence to antiepileptic drug therapy

Impact of maximum prescription length supply policy on patient medication adherence, health and economic outcomes

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