Skip to main content

Advertisement

Log in

Interventions aimed at improving performance on medication adherence metrics

  • Commentary
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

Background medication adherence is one determining factor of treatment success. Poor medication adherence mitigates optimum clinical benefits and increases total health care costs. Current evidence suggests that for population-based adherence interventions to be effective, a multidisciplinary, multifactorial approach that can be tailored for each individual should be adopted. In the United States, national organizations such as the National Committee for Quality Assurance and the Centers for Medicare and Medicaid Services include medication adherence as a metric of health care system performance Aim of the Commentary This article provides an overview of efforts at Kaiser Permanente Colorado to impact medication adherence-related metrics. Described interventions are supported by electronic data gathering processes with an emphasis on the role of pharmacists.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

References

  1. World Health Organization [Internet]. Adherence to long-term therapies: evidence for action. Geneva, Switzerland: World Health Organization; c 2003 [cited 2013 May 22]. Available from: www.who.int/chronic_conditions/en/adherence_report.pdf.

  2. Cramer J, Roy A, Burrell A, Fairchild CJ, Fuldeore MJ, Ollendorf DA, et al. Medication compliance and persistence: terminology and definitions. Value Health. 2008;11(1):44–7.

    Article  PubMed  Google Scholar 

  3. Peterson AM, Takiya L, Finley R. Meta-analysis of trials of interventions to improve medication adherence. Am J Health Syst Pharm. 2003;60(7):657–65.

    PubMed  Google Scholar 

  4. Crowley MJ, Grubber JM, Olsen MK, Bosworth HB. Factors associated with non-adherence to three hypertension self-management behaviors: preliminary data for a new instrument. J Gen Intern Med. 2012;28(1):99–106.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Yood RA, Mazor KM, Andrade SE, Emani S, Chan W, Kahler KH. Patient decision to initiate therapy for osteoporosis: the influence of knowledge and beliefs. J Gen Intern Med. 2008;23(11):1815–21.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Shrank WH, Choudhry NK, Fischer MA, Avorn J, Powell M, Schneeweiss S, et al. The epidemiology of prescriptions abandoned at the pharmacy. Ann Intern Med. 2010;153(10):640–4.

    Article  Google Scholar 

  7. Solomon DH, Brookhart MA, Tsao P, Sundaresan D, Andrade SE, Mazor K, et al. Predictors of very low adherence with medications for osteoporosis: towards development of a clinical prediction rule. Osteoporos Int. 2011;22(6):1734–43.

    Article  Google Scholar 

  8. Krousel-Wood M, Islam T, Muntner P, Holt E, Joyce C, Morisky DE, et al. Association of depression with antihypertensive medication adherence in older adults: cross-sectional and longitudinal findings from CoSMO. Ann Behav Med. 2010;40(3):248–57.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Zeller A, Taegtmeyer A, Martina B, Battegay E, Tschudi P. Physicians’ ability to predict patients’ adherence to antihypertensive medication in primary care. Hypertens Res. 2008;31(9):1765–71.

    Article  PubMed  Google Scholar 

  10. McHorney CA. The adherence estimator: a brief, proximal screener for patient propensity to adhere to prescription medications for chronic disease. Curr Med Res Opin. 2009;25(1):215–38.

    Article  PubMed  Google Scholar 

  11. Zeller A, Schroeder K, Peters TJ. An adherence self-report questionnaire facilitated the differentiation between non-adherence and nonresponse to antihypertensive treatment. J Clin Epidemiol. 2008;61(3):282–8.

    Article  PubMed  Google Scholar 

  12. Kim MT, Hill MN, Bone LR, Levine DM. Development and testing of the Hill-Bone compliance to high blood pressure therapy scale. Prog Cardiovasc Nurs. 2000;15:90–6.

    Article  CAS  PubMed  Google Scholar 

  13. Raebel MA, Schmittdiel J, Karter AJ, Konieczny JF, Steiner JF. Standardizing terminology and definitions of medication adherence and persistence in research employing electronic databases. Med Care. 2013;51(8 Suppl 3):S11–21.

    Article  PubMed  Google Scholar 

  14. PQA Pharmacy Quality Alliance [Internet]. Virginia: Pharmacy Quality Alliance; [cited 2013 May 22]. Available from: http://www.pqaalliance.org/.

  15. Viswanathan M, Golin CE, Jones CD, Ashok M, Blalock S, Wines RCM, et al. Medication adherence interventions: comparative effectiveness. Closing the quality gap: revisiting the state of the science. Evidence Report No. 208. (Prepared by RTI International–University of North Carolina Evidence-based Practice Center under Contract No. 290-2007-10056-I.) AHRQ Publication No. 12-E010-EF. Rockville, MD: Agency for Healthcare Research and Quality. September 2012. www.effectivehealthcare.ahrq.gov/reports/final.cfm.

  16. Steiner JF, Ho PM, Beaty BL, Dickinson LM, Hanratty R, Zeng C, et al. Sociodemographic and clinical characteristics are not clinically useful predictors of refill adherence in patients with hypertension. Circ Cardiovasc Qual Outcomes. 2009;2(5):451–7.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Chan DC, Shrank WH, Cutler D, Jan S, Fischer MA, Liu J, et al. Patient, physician, and payment predictors of statin adherence. Med Care. 2010;48(3):196–202.

    Article  PubMed  Google Scholar 

  18. Raebel MA, Ellis JL, Carroll NM, Bayliss EA, McGinnis B, Schroeder EB, et al. Characteristics of patients with primary nonadherence to medications for hypertension, diabetes, and lipid disorders. J Gen Intern Med. 2012;27(1):57–64.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Sokol MC, McGuigan KA, Verbrugge RR, Epstein RS. Impact of medication adherence on hospitalization risk and healthcare cost. Med Care. 2005;43(6):521–30.

    Article  PubMed  Google Scholar 

  20. Bosworth HB, Granger BB, Mendys P, Brindis R, Burkholder R, Czajkowski SM, et al. Medication adherence: a call for action. Am Heart J. 2011;162(3):412–24.

    Article  PubMed  Google Scholar 

  21. Ho PM, Rumsfeld JS, Masoudi FA, McClure DL, Plomondon ME, Steiner JF, et al. Effect of medication nonadherence on hospitalization and mortality among patients with diabetes mellitus. Arch Intern Med. 2006;166(17):1836–41.

    Article  PubMed  Google Scholar 

  22. Simpson SH, Eurich DT, Majumdar SR, Padwal RS, Tsuyuki RT, Varney J, et al. A meta-analysis of the association between adherence to drug therapy and mortality. BMJ. 2006;333(7557):15.

    Article  PubMed  Google Scholar 

  23. Balkrishnan R. The importance of medication adherence in improving chronic-disease related outcomes: what we know and what we need to further know. Med Care. 2005;43(6):517–20.

    Article  PubMed  Google Scholar 

  24. Walker EA, Molitch M, Kramer MK, Kahn S, Ma Y, Edelstein S, et al. Adherence to preventive medications: predictors and outcomes in the Diabetes Prevention Program. Diab Care. 2006;29(9):1997–2002.

    Article  Google Scholar 

  25. Wu JR, Moser DK, DeJong MJ, Rayens MK, Chung ML, Riegel B, et al. Defining an evidence-based cutpoint for medication adherence in heart failure. Am Heart J. 2009;157(2):285–91.

    Article  PubMed Central  PubMed  Google Scholar 

  26. McGinnis BD, Olson KL, Delate TMA, Stolcpart RS. Statin adherence and mortality in patients enrolled in a secondary prevention program. Am J Manag Care. 2009;15(10):689–95.

    PubMed  Google Scholar 

  27. Ho PM, Magid DJ, Shetterly SM, Olson KL, Peterson PN, Masoudi FA, et al. Importance of therapy intensification and medication nonadherence for blood pressure control in patients with coronary disease. Arch Intern Med. 2008;168(3):271–6.

    Article  PubMed  Google Scholar 

  28. McCombs JS, Nichol MB, Newman CM, Sclar DA. The costs of interrupting antihypertensive drug therapy in a Medicaid population. Med Care. 1994;32(3):214–26.

    Article  CAS  PubMed  Google Scholar 

  29. Osterburg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353(5):487–97.

    Article  Google Scholar 

  30. Cutler DM, Everett W. Thinking outside the pillbox—medication adherence as a priority for health care reform. N Engl J Med. 2010;362(17):1553–5.

    Article  CAS  PubMed  Google Scholar 

  31. Roebuck MC, Liberman JN, Gemmill-Toyama M. Medication adherence leads to lower health care use and costs despite increased drug spending. Health Aff. 2011;30(1):91–9.

    Article  Google Scholar 

  32. NCQA [Internet]. [Washington DC]: National Committee for Quality Assurance; [cited 2013 June 6]. Available from: http://www.ncqa.org/HEDISQualityMeasurement.aspx.

  33. Centers for Medicare and Medicaid Services [Internet]. Baltimore: Centers for Medicare and Medicaid Services; [cited 2013 May 22]. Available from: http://www.cms.gov/.

  34. Helling DK, Nelson K, Ramirez JE, Humphries TL. Kaiser Permanente Colorado Region Pharmacy Department: innovative leader in pharmacy practice. J Am Pharm Assoc. 2006;46(1):67–76.

    Article  Google Scholar 

  35. Steiner JF. Rethinking adherence. Ann Intern Med. 2012;157(8):580–5.

    Article  PubMed  Google Scholar 

  36. Touchette DR, Shapiro NL. Medication compliance, adherence, and persistence: current status of behavioral and education interventions to improve outcomes. J Manag Care Pharm. 2008;14(6):S2–10.

    Google Scholar 

  37. Schroeder K, Fahey T, Ebrahim S. Interventions for improving adherence to treatment in patients with high blood pressure in ambulatory settings. Cochrane Database Syst Rev. 2004;2:CD004804.

    PubMed  Google Scholar 

  38. Schedlbauer A, Davies P, Fahey T. Intervention to improve patients’ drug-taking behavior to lipid lowering drugs. Cochrane Database Syst Rev. 2010;3:004371.

    Google Scholar 

  39. Taitel M, Jiang J, Rudkin K, Ewing S, Duncan I. The impact of pharmacist face-to-face counseling to improve medication adherence among patients initiating statin therapy. Patient Prefer Adherence. 2012;6:323–9.

    Article  PubMed Central  PubMed  Google Scholar 

  40. Vervolet M, Linn AJ, Van Weert JCM, de Bakker DH, Bouvy ML, Van Djk L. The effectiveness of interventions using electronic reminders to improve adherence to chronic medication: a systematic review of the literature. J Am Med Inform Assoc. 2011;19(5):696–704.

    Article  Google Scholar 

  41. Granger BB, Bosworth HB. Medication adherence: emerging use of technology. Curr Opin Cardiol. 2011;26(4):279–87.

    Article  PubMed Central  PubMed  Google Scholar 

  42. Oyekan E, Nimalasuriya A, Martin J, Scott R, Dudl RJ, Green K. The B-SMART appropriate medication-use process: a guide for clinicians to help patients—part 1: barriers, solutions, and motivation. Perm J. 2009;13(1):62–9.

    PubMed Central  PubMed  Google Scholar 

  43. Viswanathan M, Golin CE, Jones CD, Ashok M, Blalock SJ, Wines RC, et al. Interventions to improve adherence to self-administered medications for chronic diseases in the United States: a systematic review. Ann Intern Med. 2012;157(11):785–95.

    Article  PubMed  Google Scholar 

  44. Topinková E, Baeyens JP, Michel JP, Lang PO. Evidence-based strategies for the optimization of pharmacotherapy in older people. Drugs Aging. 2012;29(6):477–94.

    Article  PubMed  Google Scholar 

  45. Pellegrino AN, Martin MT, Tilton JJ, Touchette DR. Medication therapy management: definitions and outcomes. Drugs. 2009;69(4):393–406.

    Article  PubMed  Google Scholar 

Download references

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Conflicts of interest

All authors are employed by KPCO and declare no other conflicts of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Brandy McGinnis.

Rights and permissions

Reprints and permissions

About this article

Cite this article

McGinnis, B., Kauffman, Y., Olson, K.L. et al. Interventions aimed at improving performance on medication adherence metrics. Int J Clin Pharm 36, 20–25 (2014). https://doi.org/10.1007/s11096-013-9872-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-013-9872-y

Keywords

Navigation