Cv2 Medication Refill Persistence: Does Prescription Cost-Sharing Matter?

Zhang, D; Carlson, Angeline M.; Gleason, PP; Jc, Schommer; Be, Dowd; Heaton, AH

doi:10.1016/s1098-3015(10)68539-7

Cited by 2 publications

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“…No standardized permissible gap typically exists, as this will often be dictated by the length of previous prescriptions. However, a range of 1.5-3 times the days’ supply of preceding prescription has often been used [ 37 ]. We will consider all studies that report sample-level persistence rates, whether based on a defined permissible gap or where there is evidence of discontinuation, such as patient self-reports.…”

Section: Methodsmentioning

confidence: 99%

Patterns and Predictors of Adherence to Statin Therapy Among Older Patients: Protocol for a Systematic Review

et al. 2017

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BackgroundThe benefits of statin therapy are significantly compromised by noncompliance. Although elderly patients may have particular challenges with medication adherence and persistence, previous reviews on statin adherence have not focused on this population. Additionally, comparisons of adherence and persistence specific to statin indication (primary or secondary prevention) have not been thoroughly explored.ObjectiveWe aim to assess the extent of, and factors associated with, adherence and persistence to statin therapy among older populations (aged ≥65 years).MethodsA systematic review will be undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. Searches will be performed using multiple electronic databases (Ovid MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, and the National Health Service Economic Evaluation Database) to identify relevant randomized trials and observational studies that evaluated statin adherence and/or persistence as an outcome. Eligible studies will include those involving community-living or outpatient elderly individuals. The methodological quality of randomized controlled trials (RCTs) will be assessed via the Joanna Briggs Institute’s critical appraisal checklist for RCTs, and the quality assessment of observational studies will be undertaken using a set of questions formulated with resort to the National Institute of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. When possible, meta-analyses will be conducted using random-effect modeling and generic inverse variance analyses for adjusted-effect estimates. Heterogeneity across studies will be quantified using the I2 statistic. The presence of publication bias will be assessed using funnel plots and Egger’s regression tests. A leave-one-out sensitivity analysis will also be conducted to assess the impact of individual study results on pooled estimates. To explore possible sources of heterogeneity across studies, subgroup analyses will be performed based on covariates such as study design, statin indication, country of study, and length of patient follow-up.ResultsThe electronic database searches were completed in December 2016. Retrieved articles are currently being screened and the entire study is expected to be completed by June 2017.ConclusionsThis systematic review will provide further understanding of the patterns of, and barriers to, statin adherence and persistence among older patients. The findings will inform clinical practice and the design of appropriate interventions.Trial RegistrationPROSPERO CRD42016053191

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Section: Methodsmentioning

confidence: 99%

Patterns and Predictors of Adherence to Statin Therapy Among Older Patients: Protocol for a Systematic Review

et al. 2017

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PCV72 Chronic Medication Adherence: Its Association with Health Care Costs

Zhou

Carlson²,

Gleason

et al. 2012

Value in Health

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OBJECTIVES:To evaluate primary nonadherence [PNA] to cholesterol medications and compare health care outcomes between primary adherent and nonadherent patients. METHODS: This retrospective cohort study identified all patients who were treatment-naïve to antihyperlipidemics patients with at least one new cholesterol prescription written during the period of December 1, 2009 to February 28, 2010. PNA was defined as the failure to fill a prescription within 90 days of when it was written [index date]. Patients were followed for 18 months after the index date for healthcare outcomes of low-density lipoprotein [LDL] values, cardiac/stroke events, ER visits and all-cause or cardiac/stroke-related hospitalizations. Descriptive statistics were used to compare baseline characteristics and health care outcomes between primary adherent and nonadherent patients. Cox proportional hazard models were used to estimate the hazard ratio [HR] as a measure of the relative risk of each event in the primary nonadherent in comparison to the primary adherent after controlling for patient and physician characteristics. Patients were censored at the end of the follow-up period. RESULTS: A total 17,400 patients were identified during the study period and 15% were primary nonadherent. At baseline, primary nonadherent patients were sicker than primary adherent patients with significantly higher Charlson comorbidity index values, prescription use, ER visits and hospitalizations in the prior year. LDL values decreased after the index date for both groups, but primary adherent patients had a significantly greater decrease in LDL values on average [-37.2 vs. -14.9 (pϽ0.0001)]. After adjusting for baseline covariates, the resulting HR (95%CI) was 0.83 (0.69, 0.99) for cardiac/ stroke events, 0.99 (0.91, 1.09) for ER visits, 0.87 (0.77, 0.99) for all-cause hospitalization, and 0.72 (0.44, 1.12) for CV-related hospitalization. CONCLUSIONS: Primary nonadherent patients experienced smaller decreases in LDL values, but were not found to be at increased risk for cardiac/stroke events, ER visits or hospitalization during the follow-up period.

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Cv2 Medication Refill Persistence: Does Prescription Cost-Sharing Matter?

Cited by 2 publications

References 0 publications

Patterns and Predictors of Adherence to Statin Therapy Among Older Patients: Protocol for a Systematic Review

Patterns and Predictors of Adherence to Statin Therapy Among Older Patients: Protocol for a Systematic Review

PCV72 Chronic Medication Adherence: Its Association with Health Care Costs

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