New CVS Health research pinpoints tendency toward non-adherence

WOONSOCKET, R.I. — A new study by researchers at the CVS Health Research Institute and Brigham and Women's Hospital provides evidence that patients' patterns of medication fills in the first few months after starting on a chronic therapy accurately predict future medication adherence behavior. The study, published in The American Journal of Managed Care, suggests that this approach may help quickly identify those patients most likely to benefit from medication adherence interventions. 

 

"This approach is helping us better target interventions to those patients who are most likely to benefit because trajectory modeling differentiates between patients who struggle with adherence at different times during their treatment," said William Shrank, SVP and chief scientific officer, CVS Health and study co-author. "It can also be easily replicated and available to support a wide spectrum of payors and providers who are attempting to improve the quality and reduce the costs of health care. Increasingly, we are finding that, through better analytics, we can deliver the right intervention to the right patient at the right time."

 

"With the increasing availability of rich patient data, we can better anticipate how the patients we manage will take their medications," said Niteesh Choudhry, associate physician, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital and associate professor, Harvard Medical School and the study's senior author. "This research shows that by focusing on a patient's initial, short-term medication filling behavior – are they or are they not refilling their prescription on time during the first few months of therapy – we can predict with great precision whether a patient will continue to take the medication as prescribed over the long-term."

 

The study included claims data from more than 77,000 Medicare beneficiaries that began taking a statin or statin combination drug over a three year period and whose pharmacy benefits are administered by CVS/caremark, the pharmacy benefit management company of CVS Health. Based on patterns of prescription filling over the year following therapy initiation, the researchers used group-based trajectory models to classify patients into six adherence trajectories–ranging from non-adherent to near-perfect adherence–to help capture both duration and intensity of medication taking. 

 

The results showed that patient patterns of initial medication filling in the first two to four months following initiation of a prescription accurately predicted future adherence behavior, allowing precise prediction of the patterns of medication taking over the subsequent year.