Change in Proportion of Days Covered for Statins Following Implementation of a Pharmacy Student Adherence Outreach Program.

Abstract

Nearly half of statin users discontinue therapy within the first year of treatment. Nonadherence to statin therapy may lead to an increased risk of atherosclerotic cardiovascular disease and, thus, higher costs due to hospitalizations. Value-based care models, such as accountable care organizations (ACO), are measured on adherence rates to statins through proportion of days covered (PDC). However, there is little research describing pharmacy student-based interventions within value-based care models. To (a) identify mean change in PDC for statins following implementation of a pharmacy student adherence outreach program and (b) identify the proportion of patients converted to PDC ≥ 0.80 following the implementation of the outreach program. This single-center retrospective quasi-experimental study included patients actively enrolled in a Humana Medicare Advantage Prescription Drug (MA-PD) plan who completed at least 1 adherence outreach telephone call performed by a pharmacy student between January 1, 2017, and December 31, 2017. 99 patients met inclusion criteria. Atorvastatin was the most commonly prescribed statin (43%), followed by simvastatin (38%). Sixty-four percent of patients had a baseline PDC of < 0.80. Mean (SD) PDC was 0.66 (±0.24) before the pharmacy student adherence outreach intervention, and 0.79 (± 0.23)-a 0.13 increase-after the pharmacy student adherence outreach intervention (P < 0.001). Among patients who had PDC < 0.80 at baseline, 35% of patients (n = 35) were converted to PDC ≥ 0.80 (P < 0.001), and 5% of patients with a baseline PDC ≥ 0.80 had a decrease in PDC to < 0.80 following the intervention. Among patients enrolled in a Humana MA-PD plan within an ACO, mean PDC for statins increased following exposure to a pharmacy student adherence outreach program. One third of patients converted their PDCs to ≥ 0.80 following the intervention. Value-based care programs may consider incorporating pharmacy student services to improve adherence to statins. No outside funding supported this research. The authors have no financial conflicts of interest to disclose. At the time of conducting this research, all authors were employed at Nova Southeastern University. Preliminary results were presented as a poster at the AMCP Managed Care & Specialty Pharmacy Annual Meeting; April 23-26, 2018; Boston, MA.