Skip to main content
Journal cover image

Prescriber continuity and medication adherence for complex patients.

Publication ,  Journal Article
Hansen, RA; Voils, CI; Farley, JF; Powers, BJ; Sanders, LL; Sleath, B; Maciejewski, ML
Published in: Ann Pharmacother
March 2015

BACKGROUND: Medication adherence is a critical aspect of managing cardiometabolic conditions, including diabetes, hypertension, dyslipidemia, and heart failure. Patients who have multiple cardiometabolic conditions and multiple prescribers may be at increased risk for nonadherence. OBJECTIVE: The purpose of this study was to examine the relationship between number of prescribers, number of conditions, and refill adherence to oral medications to treat cardiometabolic conditions. METHODS: In this retrospective cohort study, 7933 veterans were identified with 1 to 4 cardiometabolic conditions. Refill adherence to oral medications for diabetes, hypertension, and dyslipidemia was measured using an administrative claims-based continuous multiple-interval gap (CMG) that estimates the percentage of days a patient did not possess medication. We dichotomized refill adherence for each condition as a CMG ≤20% for each year of analysis. Condition-specific logistic regression models estimated the relationship between refill adherence and number of cardiometabolic conditions and number of prescribers, controlling for demographic characteristics, other comorbidities, and a count of cardiometabolic drug classes used. RESULTS: Compared with patients with 1 prescriber, antihypertensive refill adherence was lower in patients seeing ≥4 prescribers (odds ratio [OR] = 0.69; 95% CI = 0.59-0.80), but the number of cardiometabolic conditions was not a significant predictor. Antidyslipidemia refill adherence was lower in patients seeing 3 prescribers (OR = 0.80; 95% CI = 0.70-0.92) or ≥4 prescribers (OR = 0.77; 95% CI = 0.64-0.91). Conversely, antidyslipidemia refill adherence improved with the number of cardiometabolic conditions, but differences were only statistically significant for ≥3 conditions (OR = 1.31; 95% CI = 1.09-1.57). In multivariate regression models, the number of conditions and number of prescribers were not significant predictors of refill adherence in the group of patients with diabetes. CONCLUSIONS: Effective management of care and medication regimens for complex patients remains an unresolved challenge, but these results suggest that medication refill adherence might be improved by minimizing the number of prescribers involved in a patient's care, at least for hypertension and dyslipidemia.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Ann Pharmacother

DOI

EISSN

1542-6270

Publication Date

March 2015

Volume

49

Issue

3

Start / End Page

293 / 302

Location

United States

Related Subject Headings

  • Veterans
  • Retrospective Studies
  • Practice Patterns, Physicians'
  • Polypharmacy
  • Pharmacology & Pharmacy
  • Odds Ratio
  • Middle Aged
  • Medication Adherence
  • Male
  • Logistic Models
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Hansen, R. A., Voils, C. I., Farley, J. F., Powers, B. J., Sanders, L. L., Sleath, B., & Maciejewski, M. L. (2015). Prescriber continuity and medication adherence for complex patients. Ann Pharmacother, 49(3), 293–302. https://doi.org/10.1177/1060028014563266
Hansen, Richard A., Corrine I. Voils, Joel F. Farley, Benjamin J. Powers, Linda L. Sanders, Betsy Sleath, and Matthew L. Maciejewski. “Prescriber continuity and medication adherence for complex patients.Ann Pharmacother 49, no. 3 (March 2015): 293–302. https://doi.org/10.1177/1060028014563266.
Hansen RA, Voils CI, Farley JF, Powers BJ, Sanders LL, Sleath B, et al. Prescriber continuity and medication adherence for complex patients. Ann Pharmacother. 2015 Mar;49(3):293–302.
Hansen, Richard A., et al. “Prescriber continuity and medication adherence for complex patients.Ann Pharmacother, vol. 49, no. 3, Mar. 2015, pp. 293–302. Pubmed, doi:10.1177/1060028014563266.
Hansen RA, Voils CI, Farley JF, Powers BJ, Sanders LL, Sleath B, Maciejewski ML. Prescriber continuity and medication adherence for complex patients. Ann Pharmacother. 2015 Mar;49(3):293–302.
Journal cover image

Published In

Ann Pharmacother

DOI

EISSN

1542-6270

Publication Date

March 2015

Volume

49

Issue

3

Start / End Page

293 / 302

Location

United States

Related Subject Headings

  • Veterans
  • Retrospective Studies
  • Practice Patterns, Physicians'
  • Polypharmacy
  • Pharmacology & Pharmacy
  • Odds Ratio
  • Middle Aged
  • Medication Adherence
  • Male
  • Logistic Models