THE IMPACT OF MEDICATION ADHERENCE ON REAL-WORLD CLINICAL AND ECONOMIC OUTCOMES: A SCOPING REVIEW OF REAL-WORLD EVIDENCE
Author(s)
Aaron B. Mendelsohn, PhD, MPH1, Hannah Evanik, PharmD (candidate)2, Trent Bishop, PharmD, MPH (candidate)3, Shellie Keast, PharmD, PhD1, Charron Long, PharmD4, Pamala A. Pawloski, PharmD1, Xintian Wu, PharmD (candidate)5, Cate M. Lockhart, PharmD, PhD1;
1Academy of Managed Care Pharmacy, Alexandria, VA, USA, 2Temple University, Philadelphia, PA, USA, 3UNC, Chapel Hill, NC, USA, 4Astellas, Northbrook, IL, USA, 5University of Buffalo, Buffalo, NY, USA
1Academy of Managed Care Pharmacy, Alexandria, VA, USA, 2Temple University, Philadelphia, PA, USA, 3UNC, Chapel Hill, NC, USA, 4Astellas, Northbrook, IL, USA, 5University of Buffalo, Buffalo, NY, USA
OBJECTIVES: Adherence to medications is critical for achieving optimal therapeutic benefits. The impact of adherence on outcomes from real-world medical care, including clinical endpoints (e.g., disease progression), healthcare resource utilization (HCRU) and cost, has not been well-characterized. We conducted a comprehensive evaluation of real-world investigations on medication adherence to assess the benefit of adherence across disease areas and medications.
METHODS: We performed a scoping literature review of articles involving adherence in the real-world setting by focusing on studies with data from secondary sources, including electronic medical records and claims data. Full text articles were identified in PubMed, EMBASE, and Web of Science databases using the following keywords: compliance, adherence, administrative claims, real-world, and observational.
RESULTS: Of 1,505 articles screened, 98 analyzed the impact of adherence for over 30 clinical conditions. The most common diseases for which the impact of adherence was examined included osteoporosis/fractures (n=14), type 2 diabetes mellitus (n=12), cardiovascular disease (n=8), and multiple sclerosis (n=8). Across diverse patient populations, settings, and methodological approaches (e.g., adherence measure used), adherence was consistently associated with positive outcomes, including reductions in disease progression/sequalae; lower HCRU (e.g., inpatient and emergency department visits); improved survival; and reduced costs. For example, every 10% improvement in adherence for oral diabetes medications (based upon proportion of days covered) was associated with a 0.1% decrease in HbA1c. Over a 50% reduction in the odds of asthma exacerbations was observed for patients with asthma adherent to combination inhaled corticosteroid and long-acting beta-agonist treatment (medication possession ratio [MPR] > 80%). The likelihood of subsequent fractures for persons with osteoporosis was 33% and 19% higher for an MPR of <50% and 50-79%, respectively, versus an MPR of > 80%.
CONCLUSIONS: These findings support the health and economic value of medication adherence and support continued efforts to enhance adherence across a wide spectrum of health conditions.
METHODS: We performed a scoping literature review of articles involving adherence in the real-world setting by focusing on studies with data from secondary sources, including electronic medical records and claims data. Full text articles were identified in PubMed, EMBASE, and Web of Science databases using the following keywords: compliance, adherence, administrative claims, real-world, and observational.
RESULTS: Of 1,505 articles screened, 98 analyzed the impact of adherence for over 30 clinical conditions. The most common diseases for which the impact of adherence was examined included osteoporosis/fractures (n=14), type 2 diabetes mellitus (n=12), cardiovascular disease (n=8), and multiple sclerosis (n=8). Across diverse patient populations, settings, and methodological approaches (e.g., adherence measure used), adherence was consistently associated with positive outcomes, including reductions in disease progression/sequalae; lower HCRU (e.g., inpatient and emergency department visits); improved survival; and reduced costs. For example, every 10% improvement in adherence for oral diabetes medications (based upon proportion of days covered) was associated with a 0.1% decrease in HbA1c. Over a 50% reduction in the odds of asthma exacerbations was observed for patients with asthma adherent to combination inhaled corticosteroid and long-acting beta-agonist treatment (medication possession ratio [MPR] > 80%). The likelihood of subsequent fractures for persons with osteoporosis was 33% and 19% higher for an MPR of <50% and 50-79%, respectively, versus an MPR of > 80%.
CONCLUSIONS: These findings support the health and economic value of medication adherence and support continued efforts to enhance adherence across a wide spectrum of health conditions.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH198
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health, Safety & Pharmacoepidemiology
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), SDC: Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), STA: Biologics & Biosimilars, STA: Multiple/Other Specialized Treatments