OBJECTIVES

To examine the association between adherence self-monitoring and pharmacy claims-based medication adherence for patients taking anti-hyperlipidemia, antihypertensive, or antidiabetic medications.

METHODS

A retrospective cohort design was used to examine adherence over 12-months for patients taking anti-hyperlipidemia, antihypertensive, or antidiabetic medications. Participants were included if they had an index script between January-July 2016 and reported their adherence status at least once during the 12-month period using a digital health program, Your Digital Health Advisor (YDHA). Part of Walgreens Balanced Rewards for healthy choicesâ program, YDHA provides small financial incentives for setting and achieving lifestyle and condition management goals such as diabetes and heart-health. It provides tasks to help patients reach their goals including tracking self-monitoring adherence. Objective adherence was measured using Walgreens pharmacy claims data. Adherence was defined as Proportion of Days Covered (PDC) and optimal adherence as PDC ≥ 80%. The Cochran-Armitage trend test assessed the dose-response effects between the frequency of self-monitoring adherence activities and objective medication adherence.

RESULTS

Participants included 2,305 unique patients taking 4,441 targeted prescriptions during the index period. Participants had a mean age of 48.8 and were 77.7% female. We found that 54.4% (n=2,415) of prescriptions were taken with optimal adherence. YDHA adherence status was recorded only once for 2,803 (63%) prescriptions, twice for 670 (15%) prescriptions, and three or more times for 995 (22%) prescriptions. The Cochran-Armitage trend test showed a dose-response association for self-monitoring: patients who self-monitored adherence frequently were significantly more likely to be optimally adherent (Z=-4.6771, p<0.001).

CONCLUSIONS

Self-monitoring has been shown to improve adherence across a range of behaviors. This study demonstrated a significant positive association between participant medication self-monitoring and claims-based medication adherence. Medication adherence increased as self-monitoring became more frequent, demonstrating a dose-response association. This study shows that digital health programs such as YDHA can be leveraged to support medication adherence.