Kaiser Enhances Medication Adherence

When older patients receive longer-lived prescriptions, have lower out-of-pocket costs and access to mail order pharmaceuticals, they're more likely to adhere to regimens to treat chronic illnesses, Kaiser Permanente researchers have concluded.

Medication adherence for patients with heart problems and diabetes was about 90% if they were prescribed a 90-day supply of pills; had co-payments that were no higher than $10; had out-of-pocket maximums that were below $2,000 or less, and they used mail-order pharmacy for more than half of their refills during the calendar year. By contrast, patients without such controls in place have medication adherence of about 50%. Adherence tends to be even lower among African-Americans and Latinos, but those groups also had adherence rates in line with the averages found in the study.

“When all four of these factors are optimized, it nearly doubled the likelihood that patients adhered to prescribed medications for high blood pressure, high cholesterol and blood glucose level control,” said Julie A. Schmittdiel, a research scientist with the Kaiser Permanente Division of Research and the study’s lead author.

The data for the study was gleaned from 130,000 Kaiser enrollees living in Northern California, Northwest and Colorado who had diabetes and were over age 65 in 2010.

Schmittdiel noted that patients over 65 with diabetes are at high risk for cardiovascular events, and that the data could be used to design appropriate interventions to avoid more serious issues.

The study was funded by Kaiser's research division and the federal Agency for Healthcare Research and Quality. It was published in the most recent issue of the journal Medical Care.