title: Using aggregated pharmacy claims to identify primary nonadherence.
abstract: OBJECTIVE
  Aggregate pharmacy claims available within an electronic health record (EHR) provide an opportunity to understand primary nonadherence in real time. The objective of this study was to use pharmacy claims data available within the EHR to identify the prevalence and predictors of primary nonadherence to antihypertensive drug therapy in a multi-payer primary care network.
  
  
  METHODS
  We conducted a retrospective cohort study of patients prescribed a new antihypertensive medication in a large primary care practice network between January 2011 and September 2012.
  
  
  METHODS
  We matched prescriptions for the new antihypertensive to pharmacy claims listed in the EHR. The primary outcome was the presence of a fill for the new medication within 30 days of the prescription.
  
  
  RESULTS
  Of 791 patients in our study cohort, two-thirds (522; 66%) filled their prescription within 30 days. The majority (409; 78.4%) of that group filled the prescription on the day it was issued. Lower diastolic blood pressure and Medicare coverage increased the probability of nonadherence.
  
  
  CONCLUSIONS
  Medication fill data within the provider EHR can identify primary nonadherence in clinical practice. As adoption of this technology increases, it provides an opportunity to identify nonadherence, allowing for the effective design of interventions to improve adherence to therapy.
authors.forename: Dominique
authors.initials: D
authors.lastname: Comer
authors.forename: Joseph
authors.initials: J
authors.lastname: Couto
authors.forename: Ruth
authors.initials: R
authors.lastname: Aguiar
authors.forename: Pan
authors.initials: P
authors.lastname: Wu
authors.affiliation: Christiana Care Health System, 4755 Ogletown-Stanton Rd, Newark, DE 19718. E-mail: delliott@christianacare.org.
authors.forename: Daniel
authors.initials: D
authors.lastname: Elliott
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003691:Delaware; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D057286:Electronic Health Records; D006801:Humans; D007356:Insurance, Pharmaceutical Services; D011320:Primary Health Care; D012189:Retrospective Studies; D016903:Drug Monitoring
chemical_list: D000959:Antihypertensive Agents