Retrospective Observational Assessment of Statin Adherence Among Subjects Patronizing Different Types of Community Pharmacies in Canada

Abstract

of 2,292 (37.9%), 874 of 1,887 (46.3%), and 457 of 975 (46.9%) subjects in the department-mass merchandise, chain-franchise, and independentbanner categories, respectively, had a statin adherence level of at least 80% (P < 0.001). In logistic regression analysis, pharmacy category type was significantly associated with statin adherence; subjects in the chainfranchise and independent-banner categories were more likely to be adherent to their statin medications during their observation periods than were those in the department-mass merchandise category (adjusted odds ratio [OR] = 1.36, 95% CI = 1.23-1.50, P < 0.001 and OR = 1.39, 95% CI = 1.24-1.57, P < 0.001, respectively). From the index date through day 1,094, 1,752 of 2,292 (76.4%), 1,475 of 1,887 (78.2%), and 795 of 975 (81.5%) subjects remained pharmacy-loyal in the department-mass merchandise, chainfranchise, and independent-banner categories, respectively (P = 0.006). Controlling for several potential confounders using logistic regression, independent-banner pharmacy patrons were more likely to remain pharmacy-loyal during their observation periods than were those patronizing department-mass merchandise (adjusted OR = 1.34, 95% CI = 1.16-1.54, P < 0.001) or chain-franchise stores (adjusted OR = 1.22, 95% CI = 1.06-1.42, P = 0.009).CONCLUSION: One year after their first statin fill, subjects demonstrated low rates of adherence, ranging from 48% to 55%, regardless of the type of pharmacy they patronized. Although the differences by type of pharmacy reached statistical significance, their clinical importance is not evident, reinforcing the fact that the problem of nonadherence appears to exist among all types of community pharmacies, regardless of their categorization. Manag Care Pharm. 2009;15(6):476-84 Copyright © 2009, Academy of Managed Care Pharmacy. All rights reserved. J ABSTRACTBACKGROUND: Community pharmacies vary widely in terms of ownership structures, location, and dispensing policies. It is unknown if an association exists between the type of community pharmacy and the degree of medication adherence exhibited by patrons-patients.

First-Fill Medication Discontinuations and Nonadherence to Antihypertensive Therapy: An Observational Study

“…13 These databases have served as the basis for many observational studies of medication adherence and are considered to be of high quality. 6,[14][15][16][17] To be eligible, subjects must have been at least 40 years of age and filled a new AHT prescription in one of the following pre-specified categories: β blockers, angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, calcium channel blockers, or diuretic (thiazide and potassium-sparing). Those subjects who received a fixed-combination AHT product (two medications in a single pill/capsule) or dispensations for ≥2 distinct AHT medications on the index date were categorized as "combination therapy" (Appendix I).…”

Associations Between Statin Adherence Level, Health Care Costs, and Utilization

“…Other studies indicate that a large proportion of patients prescribed statins do not take their medicine on a regular basis. 9 Studies also show nonadherence to statin therapy is strongly associated with poor treatment outcomes. 10 Although the working population may have a relatively high adherence rate, a reason to focus on improving adherence further in the group who has not retired is the addition of smokers to those fitting the guidelines for statin therapy.…”

The impact of medication adherence on health outcomes for chronic metabolic diseases: A retrospective cohort study

“…13 Medication adherence to lipid-lowering agents was reported to be less than 100% in a year and to further fall to 33% over time. 7,[14][15][16][17][18][19][20][21][22][23] The current study builds on previous literature and assesses the impact of good medication adherence for chronic diseases including hypertension, hyperlipidemia, and diabetes on health outcomes, using nationally representative administrative claims data for 4 years (2008-2011) from the National Health Insurance in Korea. Extracting medication adherence and health outcomes from the National Health Insurance database improves the external validity of the findings given that it is nationally representative data for health services utilization and literally covers all Koreans as beneficiaries.…”