Adherence to non-vitamin-K-antagonist oral anticoagulant medications based on the Pharmacy Quality Alliance measure
| Autor: | Concetta Crivera, Steven Deitelzweig, Colleen A. McHorney, François Laliberté, Patrick Lefebvre, Brahim Bookhart, Guillaume Germain, Winnie W. Nelson, Jeffrey Schein, Silas Martin |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Pyridones medicine.drug_class Administration Oral Pharmacy Logistic regression Medication Adherence Dabigatran Cohort Studies Rivaroxaban medicine Humans Aged Retrospective Studies Aged 80 and over business.industry Anticoagulant Anticoagulants General Medicine Vitamin K antagonist Emergency medicine Physical therapy Pyrazoles Female Apixaban business medicine.drug Cohort study |
| Zdroj: | Current Medical Research and Opinion. 31:2167-2173 |
| ISSN: | 1473-4877 0300-7995 |
| DOI: | 10.1185/03007995.2015.1096242 |
| Popis: | CMS Star Ratings help inform beneficiaries about the performance of health and drug plans. Medication adherence is currently weighted at nearly half of a Part D plan's Star Ratings. Including the adherence to non-vitamin-K-antagonist oral anticoagulants (NOACs) as a measure in the Star Ratings program may increase a plan's incentives to improve patient adherence.To assess the adherence to medication of patients who used the NOACs rivaroxaban, dabigatran, or apixaban in 2014 based on the Pharmacy Quality Alliance (PQA) adherence measure.Healthcare claims from the Humana database between July 2013 and December 2014 were analyzed. Adult patients with ≥2 dispensings of NOAC agents in 2014, at least 180 days apart, with60 days of supply, and ≥180 days of continuous enrollment prior to the index NOAC were identified. The PQA measure was calculated as the percentage of patients who had a proportion of days covered (PDC) ≥0.8. Multivariate logistic regression analyses were also conducted adjusting for baseline confounders.A total of 11,095 rivaroxaban, 6548 dabigatran, and 3532 apixaban users were identified. Based on the PQA adherence measure (PDC ≥0.8), a significantly higher proportion of rivaroxaban users (72.7%) was found to be adherent compared to dabigatran (67.2%: p 0.001) and apixaban (69.5%: p 0.001) users. Compared to apixaban users, the adjusted likelihood of being adherent was significantly higher for rivaroxaban users (unadjusted OR [95% CI]: 1.17 [1.08-1.27], p 0.001; adjusted OR [95% CI]: 1.20 (1.10-1.31), p 0.001) and significantly lower for dabigatran users (unadjusted OR [95% CI]: 0.90 [0.82-0.98], p = 0.019; adjusted OR [95% CI]: 0.85 [0.77-0.93], p 0.001).Limitations of the study are potential inaccuracies in claims data, possible change in patterns over time, and the impossibility of knowing whether all supplied tablets were taken.Using the PQA's adherence measure, rivaroxaban users were found to have significantly higher adherence compared to apixaban and dabigatran users. |
| Databáze: | OpenAIRE |
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