Aimee M Banks1, Megan E Peter1, Genna M Holder2, Jacob A Jolly1, Brandon M Markley1, Scott L Zuckerman3, Leena Choi4, Sam Nwosu4, Autumn D Zuckerman1. 1. Vanderbilt Specialty Pharmacy Services, 12328Vanderbilt University Medical Center, Nashville, TN, USA. 2. St. Thomas Rutherford Hospital, Murfreesboro, TN, USA. 3. Department of Neurosurgery, 12328Vanderbilt University Medical Center, Nashville, TN, USA. 4. Department of Biostatistics, 12328Vanderbilt University Medical Center, Nashville, TN, USA.
Abstract
BACKGROUND: Disease-modifying therapy (DMT) delays disease progression and improves quality of life for patients with multiple sclerosis (MS), but adherence to DMT is often suboptimal. Vanderbilt Specialty Pharmacy (VSP) embeds pharmacists within an outpatient MS clinic to provide medication management and address barriers to adherence. OBJECTIVE: We evaluated rates and predictors of adherence to DMT among patients with MS at an integrated specialty pharmacy. METHODS: We included patients with MS who filled ≥3 DMT prescriptions from VSP during the study period. Adherence was defined as medication possession ratio (MPR) or proportion of days covered (PDC) ≥0.8. Reasons for nonadherence were collected from pharmacy claims and electronic medical records. RESULTS: The study included 653 patients. Average MPR and PDC were 0.93 and 0.94, respectively. Eighty-eight percent of patients achieved MPR ≥0.8; 89% achieved PDC ≥0.8. Using financial assistance and having $0 out-of-pocket cost were associated with higher odds of achieving MPR and PDC ≥0.8 (P < .05). Of the 12% of patients who were nonadherent, most were unreachable for refills. CONCLUSIONS: Ensuring financial assistance and low out-of-pocket costs are associated with high adherence to DMT within an integrated specialty clinic, but more work is needed to address adherence in unreachable patients.
BACKGROUND: Disease-modifying therapy (DMT) delays disease progression and improves quality of life for patients with multiple sclerosis (MS), but adherence to DMT is often suboptimal. Vanderbilt Specialty Pharmacy (VSP) embeds pharmacists within an outpatient MS clinic to provide medication management and address barriers to adherence. OBJECTIVE: We evaluated rates and predictors of adherence to DMT among patients with MS at an integrated specialty pharmacy. METHODS: We included patients with MS who filled ≥3 DMT prescriptions from VSP during the study period. Adherence was defined as medication possession ratio (MPR) or proportion of days covered (PDC) ≥0.8. Reasons for nonadherence were collected from pharmacy claims and electronic medical records. RESULTS: The study included 653 patients. Average MPR and PDC were 0.93 and 0.94, respectively. Eighty-eight percent of patients achieved MPR ≥0.8; 89% achieved PDC ≥0.8. Using financial assistance and having $0 out-of-pocket cost were associated with higher odds of achieving MPR and PDC ≥0.8 (P < .05). Of the 12% of patients who were nonadherent, most were unreachable for refills. CONCLUSIONS: Ensuring financial assistance and low out-of-pocket costs are associated with high adherence to DMT within an integrated specialty clinic, but more work is needed to address adherence in unreachable patients.
Authors: Megan E Peter; Autumn D Zuckerman; Elizabeth Cherry; David G Schlundt; Kemberlee Bonnet; Nisha Shah; Tara N Kelley Journal: PLoS One Date: 2022-08-15 Impact factor: 3.752
Authors: Autumn D Zuckerman; Nisha B Shah; Megan E Peter; Jacob A Jolly; Tara N Kelley Journal: Am J Health Syst Pharm Date: 2021-05-24 Impact factor: 2.637