OBJECTIVES: Older patients with Alzheimer’s Disease (AD) are often faced with challenges of adhering to complex medication regimens. We sought to examine the effects of Comprehensive Medication Review (CMR), a required component of the Medicare Part D Medication Therapy Management (MTM) program mostly provided by pharmacists, on medication adherence among AD patients.

METHODS: Retrospective study using 100% of Medicare claims from 2016-2017, including MTM data, linked to Area Health Resources Files. Propensity score matching was used to identify comparable treatment/comparison groups. The treatment group was comprised of new MTM enrollees in 2017 who received CMR. Individuals in the comparison group were non-MTM enrollees who met the MTM eligibility criteria. A difference-in-difference analysis was conducted by including in a multivariate logistic regression an interaction term between CMR and year 2017. The outcomes were measured by non-adherence (proportions of days covered under 80%) to diabetes, hypertension, and hyperlipidemia medications.

PARTICIPANTS: Medicare beneficiaries aged ≥65 with AD (N = 129,820).

RESULTS: Unadjusted comparisons indicated that the proportions of non-adherence in the treatment group experienced higher reduction from 2016 to 2017 than the comparison group. For instance, medication non-adherence rates to diabetes medications decreased from 13.10% in 2016 to 9.78% in 2017 in the treatment group. These rates changed from 10.84% to 12.08% among the comparison group. In adjusted analyses, reduction in medication non-adherence among the treatment group was still higher: the odds ratios for the interaction term were 0.62 (95% CI= 0.54-0.71), 0.54 (95% CI = 0.50-0.58), and 0.50 (95% CI = 0.47-0.53) for diabetes, hypertension, and hyperlipidemia medications, respectively.

CONCLUSIONS: CMR was found to have reduced nonadherence to medications for diabetes, hypertension, and hyperlipidemia among older Medicare beneficiaries with AD. The results provided evidence of the effectiveness of the Medicare Part D MTM program for a population with unique medication compliance challenges.