Primary nonadherence has been a barrier to optimal hypertension management. Claims data can help identify patients who need interventions to improve compliance.
Pharmacy claims data may be useful in cases of nonadherence to antihypertensive medications, suggested a study published in the January 4 online edition of the American Journal of Managed Care.
To better understand nonadherence, the research team of pharmacists and physicians reviewed pharmacy claims data available through electronic health records (EHRs).
Dominique Comer“Primary nonadherence is an increasingly identified barrier to optimal hypertension management. However, the ability to intervene has been limited by the lack of pharmacy claims records available in clinical practice in nonintegrated delivery systems,” wrote Dominique Comer, PharmD, MS, senior clinical researcher, Christiana Care Value Institute, Philadelphia, Penn.
After reviewing EHRs in the Surescripts network, the researchers found no evidence that one-third of patients prescribed a new antihypertensive medication had filled the Rx within 30 days.
“This is consistent with Fischer et al, who identified a 28.4% incidence of primary nonadherence in a similar cohort. Lower rates of primary nonadherence have been found in studies within integrated delivery systems, perhaps reflecting the ability of an integrated delivery system to capture more complete medication refill history,” Comer wrote.
History not available
Only 791 of 3,284 patients who were prescribed an antihypertensive drug met the study requirements. “This was largely due to the fact that the pharmacy fill history was not available because the provider had not accessed the medication history after the new prescription.”
However, the researchers did find that primary nonadherence was associated with increasing medication burden, age, and noncardiovascular comorbidities. “This is consistent with previous literature suggesting that medication nonadherence may increase as competing comorbidities, particularly with active symptoms, take precedence over asymptomatic conditions such as hypertension,” Comer wrote.
“Our results showed that the majority of patients who do fill their medications do so on the day it is prescribed, suggesting that interventions could be applied in the first few days following prescription. This approach has been used to improve the proportion of patients who fill statin prescriptions,” Comer wrote.