Improving Asthma Adherence

A new study, published in the Journal of Allergy and Clinical Immunology, shows that patients who are more confident about the benefits of their asthma controller therapies tend to report higher levels of adherence.

The Trial of Asthma Patient Education (TAPE) study examined the effect of an educational program aimed at increasing expectations of treatment benefit on medication adherence.

Patients with sub-optimally controlled asthma were randomized to either placebo or the active drug – montelukast (Singulair) in conjunction with an interactive computer-based multimedia educational presentation that was either neutral or designed to increase outcome expectancy.

The enhanced presentation was specifically designed to increase the expectation that the drug would adequately control asthma symptoms, while the neutral presentation included information on asthma care and management but without active promotion of the benefits of medication. The presentations were shown before the study drugs were dispensed, and again 2 weeks into the study.

Adherence was monitored electronically over 4 weeks and was defined as ≥80% use of prescribed doses. Medication adherence was measured electronically using devices fitted onto the medication bottles to record the date and time of each bottle opening.

Outcome expectancy, peak expiratory flow, prebronchodilator FEV₁, asthma control (Juniper asthma control questionnaire), and asthma-related quality of life were assessed at baseline and at the 4-week follow-up.

Results showed that the enhanced presentation mode was associated with improved adherence to active drug. Additionally, when a patient expected a higher benefit from treatment, their breathing test scores improved and self-reported asthma control scores tended to be higher. There was also an accompanying trend for improvement in asthma-specific quality of life.

These results suggest that the manner in which medications are introduced to patients may not only affect their expectations about the potential benefits of the therapy, but may also impact their level of adherence and sense of improved health. The authors dubbed this The Madison Avenue effect.

This study further supports the results of work undertaken by SRxA’s Health Outcomes Advisors:  Dr. Allan Luskin and Dr. Don Bukstein.  Together with SRxA, Drs Luskin and Bukstein, both world authorities on Health Outcomes, have developed fully integrated Practice Management programs to improve medication adherence and patient outcomes. These programs can be customized for almost any drug or treatment modality.  Pharmaceutical companies wanting to know more about these guaranteed result programs should contact us today.

Prescription Abandonment

You get sick, you go to the doctor, he or she writes you a prescription for some pills, you take it to the pharmacy and then…   Logic would suggest that the next steps would be that you pick up the prescription, take the medicine and get better.

Well, not always.  According to a new study published in the Annals of Internal Medicine almost 2% of these prescriptions are never picked up.

Using databases from a large retail pharmacy chain and a pharmacy benefits manager, researchers examined factors associated with prescription abandonment over a 3-month period.

Unsurprisingly, drugs with high copayments are the most likely to go unclaimed.  Prescriptions with copayments of $40 to $50 and prescriptions costing more than $50 were 3.40 times and 4.68 times more likely, respectively, to be abandoned than prescriptions with no copayment.

In addition, electronic prescriptions were 1.6 times more likely than non-electronic prescriptions to be left behind, and new prescriptions were almost three times more likely to be abandoned than previously filled prescriptions.

Interestingly, young adults were more likely than older patients to abandon their prescriptions, while opiates and anti-platelet agents were the least likely to be left behind.

Although the accompanying editorial called the low rate of abandonment “reassuring,” they suggest that physicians “remain mindful that costs are an important barrier to adherence and should aim to prescribe or recommend less expensive alternatives whenever feasible.”

SRxA’s Advisors can help pharmaceutical companies increase medication compliance and implement programs to lower the consumer cost of prescription drugs. Contact us today for more information.