Pharmacy refill data helps providers detect medication non-adherence

A combination of provider reports and pharmacy refill data offers the highest sensitivity for identifying and predicting medication non-adherence.

According to Johns Hopkins researchers, a study of 87 adolescents and young adults with chronic kidney disease, evaluated five adherence measures—provider reports, patient reports, caregiver reports, electronic medication monitoring and pharmacy refill data.

Specifically, the study—published in the January issue of Pediatric Nephrology—examined whether using additional measures, beyond provider assessment alone, improves the accurate identification of non-adherence.

“Providers inaccurately identify non-adherence, leading to missed opportunities to intervene,” state the authors. “Our study demonstrates the benefit to utilizing a multi-method approach to identify non-adherence in patients with chronic disease, an essential first step to reduce non-adherence.”

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While sensitivity (0.57) and specificity (0.77) demonstrated poor agreement between provider reporting and electronic medication monitoring, researchers found that combining provider reports and pharmacy refill data resulted in the highest sensitivity for identifying non-adherence (0.90) and negative predictive power (0.88).

“In general, providers are already doing assessments of patients’ adherence levels, and most clinical practices have the ability to access pharmacy refill data, so this is a very feasible thing to start doing in a clinical setting,” says Cozumel Pruette, MD, first author and assistant professor of pediatrics at Johns Hopkins Children’s Center.

“We can’t say what other specific populations our findings apply to, but it’s likely generalizable that some kind of multi-modal approach is really the most meaningful in identifying non-adherence and providing us with the greatest level of information to help patients improve their adherence,” adds Pruette.

However, she contends that more research is needed to demonstrate whether the combination of provider assessment and pharmacy data is the best way to measure adherence levels in other patient populations.