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Recently, we found that veterans with one VA prescriber of cardiometabolic medications in a single Veterans Affairs (VA) medical center had higher medication refill adherence [ 6] and lower emergency department and hospital utilization than veterans with multiple prescribers [ 2].
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.
Therefore, dispensing records provide reliable and unbiased information on medication refill adherence and regimen potency.
Karter et al. (7) reported that missing scheduled medical appointments was associated with higher HbA1c levels a predictor of mortality and with poor oral medication refill adherence.
Hess et al. suggest that CMA and MPR, along with Continuous Multiple Interval Measure of Oversupply (CMOS) and Medication Refill Adherence (MRA), provide identical adherence measuring power [ 28].
By contrast they seem to use MPR (and equivalently the Medication Refill Adherence percentage) to refer to the total days' supply divided by the entire observation window [i.e., (n1+ n2+ … + nk) / (te – t0)].
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The reasons for these differences are likely multifactorial and may be related to provider experience, structural factors such as convenience of medication refills, patient adherence, stigma and levels of patient disclosure to others, and initial treatment regimen used, including drug side effects and tolerance [27,28].
Among non-LIS Medicare Part D beneficiaries, those who had coverage in the gap had higher total expenditures, and modestly lower out-of-pocket costs, but did not have consistently higher medication refills or adherence relative to non-LIS/non-GC beneficiaries.
Such data allows quantification of medication adherence to various refill adherence measures.
Studies investigating whether generic medication and generic substitution affect refill adherence report that adherence is higher among patients who start treatment with generics, compared to those who start with brand-name drugs [ 7, 9].
As direct measurement of medication consumption is usually not feasible, refill adherence has been applied as an estimate of adherence in population-based studies [ 54].
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CEO of Professional Science Editing for Scientists @ prosciediting.com