The first publication of ABC Project

The ABC project (Ascertaining Barriers for Compliance) is funded by the European Commission within the Seventh Framework Programme for research and technological development. The first ABC Project article entitled Management of patient adherence to medications: protocol for an online survey of doctors, pharmacists and nurses in Europe has been published by BMJ Open.  At this tiem, it has been the largest survey of European healthcare professionals' medication adherence perceptions, beliefs and behaviours. 

The article can be accessed here. 

Predictors of Primary Medication Nonadherence

Fischer et al. Trouble Getting Started: Predictors of Primary Medication Nonadherence

The American Journal of Medicine 124(11);1081.e9-22

Abstract

Background

Patient nonadherence to prescribed medication is common and limits the effectiveness of treatment for many conditions. Most adherence studies evaluate behavior only among patients who have filled a first prescription. The advent of electronic prescribing (e-prescribing) systems provides the opportunity to track initial prescriptions and identify nonadherence that may have previously been undetected.

Methods

We analyzed e-prescribing data and filled claims for all patients with CVS Caremark (Woonsocket, RI) drug coverage who received e-prescriptions from the iScribe e-prescribing system in calendar 2008. We matched e-prescriptions with filled claims by using data on the drug name, date of e-prescription, and date of filled claims, allowing up to 180 days for patients to fill e-prescriptions. We evaluated the rate of primary nonadherence to newly prescribed medications across multiple characteristics of patients, prescribers, and prescriptions and developed multivariable models to identify predictors of nonadherence.

Results

We identified 423,616 e-prescriptions for new medications, with 3634 prescribers and 280,081 patients. The primary nonadherence rate was 24.0%. Several factors were associated with nonadherence to e-prescriptions, including nonformulary status of medications (odds ratio [OR] 1.31 compared with preferred medications; 95% confidence interval [CI], 1.26-1.36; P<.001) and residence in a low-income ZIP code (OR 1.23 compared with high-income ZIP code; 95% CI, 1.17-1.30; P<.001) Nonadherence occurred less often when e-prescriptions were transmitted directly to the pharmacy rather than printed to give to patients (OR 0.54; 95% CI, 0.52-0.57; P<.001).

Conclusion

24% of e-prescriptions for new medications were not filled. Our results suggest that interventions to address economic barriers and increase electronic integration in the healthcare system may be promising approaches to improve medication adherence.

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Free Medications Could Improve Adherence: MI FREEE trial

Eliminating drug copayments for patients following a myocardial infarction reduced vascular events without increasing overall costs for insurers in the prospective randomized MI FREEE trial.

Although the Post-Myocardial Infarction Free Rx Event and Economic Evaluation trial had only a "modest" impact on medication adherence and missed its primary end point, the findings were dramatic enough that study sponsor Aetna has announced it will waive copayments for its post-MI patients beginning January 2013, lead author Dr. Niteesh Choudhry said at the annual scientific sessions of the American Heart Association.

To read more click here: Internal Medicine News