OBJECTIVE: To determine the effect of medication burden on persistent use of newly added lipid-lowering (LL) drugs among patients with hypertension. STUDY DESIGN: This retrospective database study used medical and pharmacy claims from a mid-Atlantic managed care organization. The cohort was obtained from continuous member enrollment in pharmacy and medical benefits from January 1, 2003, to December 31, 2005. METHODS: Prescription claims were obtained for 18 months following the date of the first filled LL prescription (ie, index date). Patients were stratified into patients who changed LL drug or strength (group 1) and patients who did not change LL drug or strength (group 2). The primary outcome measure was persistence to newly added LL therapy. Persistence was defined by the length of time a member remained on therapy following the index date. The secondary outcome measure was the medication possession ratio (MPR). The MPR was calculated as the ratio of the sum of the days' supply of prescription filled divided by the number of days filled, plus the days' supply for the final prescription fill. Associations between the daily medication burden, defined as the number of unique drug products, and the outcome measures were analyzed. RESULTS: In the cohort of 3058 patients, the mean medication burden was 2.9 medications. Medication burden was positively associated with persistence and MPR through 18 months. Patients who had greater medication burden had longer persistence (P <.001). Likewise, patients who had greater medication burden had higher MPRs and were more likely to be considered adherent (MPR, >80%) (P < .001 for both). CONCLUSIONS: Patients with higher medication burden had greater adherence to newly added LL therapy. Medication burden should not deter clinicians from adding LL therapy. Among patients with added LL therapy, more attention should focus on patients who have changes to their LL regimen compared with patients who continue on the same LL prescription.
OBJECTIVE: To determine the effect of medication burden on persistent use of newly added lipid-lowering (LL) drugs among patients with hypertension. STUDY DESIGN: This retrospective database study used medical and pharmacy claims from a mid-Atlantic managed care organization. The cohort was obtained from continuous member enrollment in pharmacy and medical benefits from January 1, 2003, to December 31, 2005. METHODS: Prescription claims were obtained for 18 months following the date of the first filled LL prescription (ie, index date). Patients were stratified into patients who changed LL drug or strength (group 1) and patients who did not change LL drug or strength (group 2). The primary outcome measure was persistence to newly added LL therapy. Persistence was defined by the length of time a member remained on therapy following the index date. The secondary outcome measure was the medication possession ratio (MPR). The MPR was calculated as the ratio of the sum of the days' supply of prescription filled divided by the number of days filled, plus the days' supply for the final prescription fill. Associations between the daily medication burden, defined as the number of unique drug products, and the outcome measures were analyzed. RESULTS: In the cohort of 3058 patients, the mean medication burden was 2.9 medications. Medication burden was positively associated with persistence and MPR through 18 months. Patients who had greater medication burden had longer persistence (P <.001). Likewise, patients who had greater medication burden had higher MPRs and were more likely to be considered adherent (MPR, >80%) (P < .001 for both). CONCLUSIONS:Patients with higher medication burden had greater adherence to newly added LL therapy. Medication burden should not deter clinicians from adding LL therapy. Among patients with added LL therapy, more attention should focus on patients who have changes to their LL regimen compared with patients who continue on the same LL prescription.
Authors: Seth D Crockett; Richard A Hansen; Til Stürmer; Robin Schectman; Jane Darter; Robert S Sandler; Michael D Kappelman Journal: Inflamm Bowel Dis Date: 2011-08-08 Impact factor: 5.325
Authors: Tom D Blydt-Hansen; Christopher B Pierce; Yi Cai; Dmitri Samsonov; Susan Massengill; Marva Moxey-Mims; Bradley A Warady; Susan L Furth Journal: Clin J Am Soc Nephrol Date: 2013-11-21 Impact factor: 8.237
Authors: Adem Sav; Michelle A King; Jennifer A Whitty; Elizabeth Kendall; Sara S McMillan; Fiona Kelly; Beth Hunter; Amanda J Wheeler Journal: Health Expect Date: 2013-01-31 Impact factor: 3.377
Authors: Michael Bauer; Tasha Glenn; Martin Alda; Kemal Sagduyu; Wendy Marsh; Paul Grof; Rodrigo Munoz; Emanuel Severus; Philipp Ritter; Peter C Whybrow Journal: Int J Bipolar Disord Date: 2013-05-03