Abstract P358: Improvement in Antihypertensive Medication Adherence and Persistence Using a Mobile Technology Application

Abstract

Background: The high costs and negative outcomes associated with poor medication adherence are well established. This study evaluated antihypertensive adherence and persistence in patients using the Medisafe personalized medication management application (app) compared to a matched control group. Methods: Patients installing the app entering an antihypertensive medication (users) between 1/1/2014-12/31/2017 (index date) were anonymously linked to IQVIA’s longitudinal prescription claims (LRx) database and matched 1:3 to non-app users (controls) with prescription claims for antihypertensive therapy in the same month as the app user; further matched on age (+/- 3 years), gender, geographic region, and categorical number of pre-index antihypertensive therapy claims (0-5, 6-11, ≥ 12). All patients had ≥ 2 prescription claims pre-index and ≥ 3 claims post-index, while pre- and post-index periods were equalized for app users and controls. Adherence was measured during the persistent period in LRx via medication possession ratio (MPR) during the pre-index and post-index periods established for both groups. Persistence was defined as no gaps in therapy >60 days. Differences in MPR change between app users and controls were tested using difference in differences (DID) models. Persistence was evaluated using Kaplan-Meyer analysis. Results: There were a total of 4,019 cases and 12,057 controls with mean (SD) pre-index periods of 14.2 (8.8) months. The mean (SD) age was 55 (12) years; 55% were male. The net increase in MPR was significantly higher in app-users compared to the controls (+0.083 vs. +0.036, p<.0001) as was the change in the proportion of patients with MPR ≥ 0.80 (+15.40% vs. +7.81%, p<.0001). Persistence on therapy was significantly higher for app users (log-rank test p<0.001) and at 12 months was 81.4% for app users compared to 34.5% for controls. Conclusions: Patients using the Medisafe app were significantly more persistent on therapy compared to matched controls and had a higher adherence to therapy during the persistent period. Broad use of this mobile app technology could play an important role in improving clinical and economic outcomes in patients with hypertension.