Medication adherence boosts biometric outcomes in diabetic patients

For patients with diabetes or high blood cholesterol, greater medication adherence is associated with a greater likelihood that the patient will achieve target biometric A1c (less than 8) and low-density lipoprotein (LDL) levels (less than 100), respectively, according to a poster session presented at the Academy of Managed Care Pharmacy meeting.

Iyengar“The study also found that two-thirds of adherent patients had biometric levels higher than the recommended targets, yet did not have a change in medication in the 180 days following their laboratory tests,” says presenter Reethi Iyengar, Express Scripts senior manager, outcomes research.

Iyengar and colleagues measured adherence, medication usage patterns and lab results for patients with diabetes and high blood cholesterol to determine an association between greater medication adherence and achieving target A1c and LDL levels. The study controlled for demographics and longevity of use.

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More specifically, the research examined the association between adherence and target levels with the help of descriptive and multivariate analysis. Descriptive analysis (chi-square) looked at the association between adherence (defined using 90- and 180-day medication possession ratio preceding the latest available biometric test date between 2011 and 2014) and biometric results (target level: <8 for A1c and <100 for LDL). Multivariate logistic regression was used to account for the confounding effect of demographics and longevity of medication use on the adherence-biometric level relationship. Medication use patterns for adherent patients with above target levels were examined for 120 days after the test and compared to 120 days before the test to ascertain any changes.

The study was conducted to better understand the “potential positive health outcomes associated with greater medication adherence in patients with chronic health conditions, and to identify additional opportunities to help adherent patients reach recommended disease management goals,” Iyengar says.

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The findings of this study further support the need for clinical programs and tools, such as the use of home delivery pharmacy, that have shown to foster greater medication adherence, according to Iyengar.

“The increased likelihood that patients with diabetes and high blood cholesterol will achieve their target biometric goals when they are more adherent to pharmacotherapy suggests that medication adherence can lead to better disease management and health outcomes,” she says.

Other research indicates that better adherence is associated with improved quality of life, and a reduced risk of medical expenditures associated with poor disease management, Iyengar adds.

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“There is also an opportunity for plan sponsors to collaborate with prescribers and their pharmacy benefit plan to ensure more timely, optimal outcomes from prescription therapy,” she says. “Adherent patients who have biometric levels above the recommended targets require a change in therapy, yet as the study demonstrates, the majority of adherent patients with above-target biometric levels did not have a change in therapy.”

Clinical programs (such as Express Scripts’ RationalMed) patient safety program, can help plan sponsors reduce omissions of care (such as under dosing), improve care coordination and close gaps in therapy.

“Greater medication adherence can have a positive impact in helping patients with a chronic condition achieve their biometric targets,” Iyengar says. “Additionally, there is an opportunity for greater collaboration between payers, benefit managers and prescribers to deliver timely and appropriate patient-centric care.”