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EHR data can help physicians identify medication adherence

Medication fill data from electronic health record systems may help primary care providers recognize and track patients who fail to fill an initial prescription, according to findings published in the American Journal of Managed Care.

Researchers found that aggregated pharmacy claims data from EHRs identified patients with primary medication nonadherence in their retrospective cohort study.

"Primary nonadherence research has relied largely on pharmacy claims within integrated delivery systems or health plans," Dominique Comer, PharmD, MS, Thomas Jefferson University, and colleagues wrote. "Historically, providers in most primary care practices, particularly those in multipayer environments, do not have access to these data to identify or monitor for nonadherence. The recent adoption of electronic-prescribing (e-prescribing) systems has made prescription fill information increasingly available to providers within their native [EHR]. This access to aggregated, multipayer pharmacy data creates an opportunity to identify and address primary nonadherence in clinical practice, possibly even in real time."

Comer and colleagues monitored 791 patients to see if they filled prescriptions for a new antihypertensive within 30 days of receiving the prescription. The patients belonged to a multispecialty practice that included 14 primary care sites that shared an EHR (Centricity, GE Healthcare). The researchers noted that the practice had begun e-prescribing in 2010 and all prescriptions were generated through the EHR system.

Results showed that 522 patients (66%) filled their prescriptions within the 30-day time frame. Of those patients, 409 (78.4%) filled their prescriptions on the day they received it.

Patients who did not fill their prescriptions were more likely to be older (OR = 1.01; 95% CI, 1-1.02), have a higher number of medications (OR = 1.04; 95% CI, 1-1.07) or have Medicare (OR = 1.61; 95% CI, 1.16-2.23). In a multivariate analysis, probability of nonadherence was higher in patients covered by Medicare (OR = 1.57; 95% CI, 1.02-2.42) and lower in patients with increasing diastolic blood pressure (OR = 0.98; 95% CI, 0.97-1).

"Primary nonadherence is associated with adverse clinical outcomes, yet can be difficult to measure in a multipayer environment," Comer and colleagues wrote. "Our study used aggregated pharmacy fill data to identify that nearly one-third of patients prescribed a new antihypertensive medication in our primary care cohort did not fill that medication within 30 days. Our findings suggest that the increased availability of medication fill histories in clinical practice can provide objective insight into a patient’s medication adherence, and may provide a foundation for targeted interventions to improve primary nonadherence." – by Chelsea Frajerman Pardes

Disclosures: The authors report no relevant financial disclosures.