Statin Adherence Rates in Patients Utilizing a Patient-Centered Medical Home-Based Pharmacy.
BACKGROUND
Medication nonadherence contributes to approximately US$290 billion per year in avoidable health-care spending. Statins are of particular interest because of their importance to patient outcomes, costs of treatment failure, and categorization as a Medicare star measure linked to financial reimbursement.


OBJECTIVE
To evaluate statin adherence as defined by the proportion of days covered (PDC) among patients who use an embedded dispensing pharmacy in a patient-centered medical home (PCMH).


METHODS
This study is a retrospective chart review of Lifetime Health Medical Group's electronic health record and third-party prescription claims data of statin therapy. Statin adherence is reported using PDC, with 0.8 or greater considered adherent for statin therapy. Statistics used include 2-sample unpaired t test to compare PDC between gender and age, and analysis of variance was used to determine differences in PDC among different insurance types.


RESULTS
One hundred ninety-three patients were included, and 917 statin prescriptions were filled. PDC for statin medications in the population was 0.92 ± 0.20. Eighty-six percent of patients were considered adherent, with a PDC ≥80%. The average insurance and patient costs for brand prescriptions (n = 106) were US$233 ± US$143 and US$31 ± US$27, respectively, and costs for generic prescriptions (n = 811) were US$8 ± US$13 and US$7 ± US$6, respectively.


CONCLUSIONS
Statin adherence rates for patients utilizing a dispensing pharmacy embedded in a large PCMH exceed the national average of 40% to 50% adherence.
1 State University of New York at Buffalo School of Pharmacy and Pharmaceutical Sciences, Department of Pharmacy Practice, Buffalo, NY, USA.
Erin M
EM
Slazak
1 State University of New York at Buffalo School of Pharmacy and Pharmaceutical Sciences, Department of Pharmacy Practice, Buffalo, NY, USA.|2 Lifetime Health Medical Group, Buffalo, NY, USA.|3 University of Rochester Medical Center, Rochester, NY, USA.
Jessica T
JT
Kozakiewicz
1 State University of New York at Buffalo School of Pharmacy and Pharmaceutical Sciences, Department of Pharmacy Practice, Buffalo, NY, USA.
Natalie S
NS
Winters
2 Lifetime Health Medical Group, Buffalo, NY, USA.|3 University of Rochester Medical Center, Rochester, NY, USA.
Jason R
JR
Smith
1 State University of New York at Buffalo School of Pharmacy and Pharmaceutical Sciences, Department of Pharmacy Practice, Buffalo, NY, USA.
Scott V
SV
Monte
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D057286:Electronic Health Records / Q000706:statistics & numerical data / Q000639:trends; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007345:Insurance Claim Review / Q000706:statistics & numerical data / Q000639:trends; D008297:Male; D018802:Patient-Centered Care / Q000706:statistics & numerical data / Q000639:trends*; D010593:Pharmaceutical Services / Q000639:trends*; D012189:Retrospective Studies; D016903:Drug Monitoring
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
adherence; ambulatory care; patient-centered medical home