OBJECTIVES:

The effectiveness of medications depends on whether patients adhere to them. Poor adherence has been associated with adverse health outcomes and increased avoidable healthcare costs. Centers for Medicare & Medicaid Services (CMS) suggest monitoring adherence for three conditions: hypertension, hypercholesterolemia, and type 2 diabetes. We assessed the impact of a pharmacist administered, targeted intervention program (TIP) on the medication adherence of non-adherent patients or patients at risk of becoming non-adherent.

METHODS:

Data from a mid-sized health insurance company in the US were assessed for the year 2021 for CMS adherence programs. Adherence, in proportion of days covered (PDC), was compared between patients with a generated and completed TIP (intervention) and patients with a generated but not completed TIP (control). A patient could be enrolled for more than one TIP. PDC ≥ 0.80 defined an “adherent” patient. Patients were followed-up quarterly (check-ins).

RESULTS: A total of 27,164 TIPs were generated with 21,945 patients enrolled (7,875 intervention, 14,070 control). Compared to control, the intervention group had a significant PDC increase of 0.029 (0.804 vs 0.775; p-value < 0.0001) and a 6.40%-point increase (64.10 vs 57.70; p-value < 0.0001) in adherent patients. For each of the conditions, significant percentage increases in adherent patient (p-value < 0.0001) were also observed; 11.30%-points (65.70 vs 54.40) for hypertension, 9.20%-points (65.30 vs 56.10) for hypercholesterolemia and 10.3%-points (68.20 vs 57.90) for type 2 diabetes. The adherence of patients with check-ins were higher (73.25% vs 55.60%) than without check-in.

CONCLUSIONS:

The analysis demonstrated that TIPs increased the percentage of adherent patients on hypertension, hypercholesterolemia, and type 2 diabetes medications. The impact of the program on health outcomes and healthcare costs still requires evaluation, though it should encourage health plans to implement or continue adherence programs as part of their overall population health strategy.