Prescription Fill Adherence in Pediatric Asthma: Are Privately Insured Children at Increased Risk?

Refill Adherence Measures and Its Association with Economic, Clinical, and Humanistic Outcomes Among Pediatric Patients: A Systematic Review

“…The studies were conducted in 10 different countries, the majority (n = 33) of which were high-income countries, according to The World Bank definition [56]. These include the United States of America (n = 23) [21][22][23][24][25][26][27]29,[31][32][33][34][35]39,41,[47][48][49][50][51][52][53][54], United Kingdom (n = 3) [30,38,46], Israel (n = 2) [43,45], Taiwan (n = 1) [42], Korea (n = 1) [37], Australia (n = 1) [55], Netherlands (n = 1) [36], and Singapore (n = 1) [44]. Only two studies were conducted in upper-middle-income countries such as Brazil (n = 1) [28], and Malaysia (n = 1) [40].…”

“…No studies were conducted in lower middle-income and low-income countries. Asthma (n = 9) was the most common disease state involved in the studies [24,25,28,30,31,[34][35][36]51], followed by human immunodeficiency virus (HIV) infection (n = 6) [21][22][23]47,49,50]. The sources of medication refill data were pharmacy records (n = 19) in approximately half of the studies, [21][22][23]28,33,35,37,40,44,[46][47][48][49][50][51][52][53][54][55], and administrative claims database (n = 16) in the remaining studies [24][25][26][27][29][30][31][32]34,36,38,39,[41][42]…”

“…Another four studies utilized RAMs involving the proportion of doses/refills collected in the study period [23,28,38,49], with ratio outputs comparable to MPR/PDC. The remaining four studies utilized the number of filled prescriptions as the RAMs [24,35,47,48].…”

“…Of the 27 studies with a fixed threshold to define adequate adherence, five studies derived its threshold from the study cohorts' percentiles or data distributions [25,27,33,36,41], while 10 studies utilized thresholds from prior studies [22,31,37,39,40,43,45,49,50,53]. The source of threshold used for the remaining 12 studies were not specified [21,24,34,35,38,42,44,[46][47][48]52,54]. Table S3 summarizes the reported relationship between medication adherence and ECHO.…”

“…Other outcomes were in HIV, such as viral load [21][22][23]47,49,50], and CD4 count [21]. Among patients with asthma, disease severity [35,51], lung function test [28,35], symptom control (exercise limitation, nocturnal symptom, morning symptoms) were assessed [28].…”