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Romanelli RJ, Huang Q, LaMori J, Doshi D, Chung S., Popul Health Manag. doi: 10.1089/pop.2017.0163. [Epub ahead of print], 2018 Mar 12
Abstract
Adherence to cardiometabolic disease (CMD) medications is typically suboptimal. This study sought to evaluate the relationship between patients' medication-related experiences of care and adherence to CMD therapy.
This study was conducted using electronic health records and administrative data from an ambulatory care setting. It included adult managed care beneficiaries with a prescription for CMD medications (antihyperlipidemic, antihypertensive, or antihyperglycemic agents) between 2010 and 2014, written ±14 days of an office encounter linked to a completed patient experience survey.
Outcomes were primary and overall adherence. Primary adherence was defined as ever filling a CMD medication and overall adherence as ≥80% days covered over 365 days among those with an initial fill. Survey items ("inclusion in treatment decisions" and "information about medications") are measured on a scale from 1 (very poor) to 5 (very good). Logistic regression was used to assess associations between ratings on each item (5 vs. <5) and primary or overall adherence. Eligibility criteria were met by 7368 patients; 5865 had ≥1 fill.
After adjusting for confounders, better patient experiences with "inclusion in treatment decisions" (adjusted odds ratio [OR]:1.16; P = 0.049) and "information about medications" (OR:1.22; P = 0.009) were associated with greater odds of overall adherence to therapy. No significant associations were found between patient experience and primary adherence. Better patient medication-related experience of care is associated with improved adherence to CMD therapy.
Efforts to include patients in treatment decision making and to provide better education on medications are simple, modifiable solutions to improve adherence and resultant outcomes of CMD treatment.