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Comparison of Pharmacy Refill Data With Chemical Adherence Testing in Assessing Medication Nonadherence in a Safety Net Hospital Setting

Authors :
David Osula
Bryan Wu
Kevin Schesing
Sandeep R. Das
Elizabeth Moss
Kristin Alvarez
Christopher Clark
Ethan A. Halm
Nancy J Brown
Wanpen Vongpatanasin
Source :
Journal of the American Heart Association. 11
Publication Year :
2022
Publisher :
Ovid Technologies (Wolters Kluwer Health), 2022.

Abstract

Background Pharmacy fill data are a practical tool for assessing medication nonadherence. However, previous studies have not compared the accuracy of pharmacy fill data to measurement of plasma drug levels, or chemical adherence testing (CAT). Methods and Results We performed a cross‐sectional study in patients with uncontrolled hypertension in outpatient clinics in a safety net health system. Plasma samples were obtained for measurement of common cardiovascular drugs, including calcium channel blockers, thiazide diuretics, beta blockers, angiotensin‐converting enzyme inhibitors/angiotensin receptor blockers, and statins, using liquid chromatography mass spectrometry. Proportion of days covered (PDC), a method for tracking pharmacy fill data, was calculated via linkages with Surescripts, and its diagnostic test characteristics were compared with CAT. Among 77 patients with uncontrolled hypertension, 13 (17%) were nonadherent to at least 1 antihypertensive drug and 23 (37%) were nonadherent to statins by CAT. PDC was significantly lower in the nonadherent versus the adherent group by CAT only among patients prescribed an angiotensin‐converting enzyme inhibitor/angiotensin receptor blocker or statin (all P Conclusions PDC is useful in detecting nonadherence to angiotensin‐converting enzyme inhibitors/angiotensin receptor blockers and statins but has limited usefulness in detecting nonadherence to calcium channel blockers, beta blockers, or thiazide diuretics and has a low positive predictive value for all drug classes.

Details

ISSN :
20479980
Volume :
11
Database :
OpenAIRE
Journal :
Journal of the American Heart Association
Accession number :
edsair.doi.dedup.....2d5775eec5b3e308d6be62ed70437914
Full Text :
https://doi.org/10.1161/jaha.122.027099