Evaluating Medication Day-Supply for Improving Adherence and Clinical Biomarkers of Hemoglobin A1c, Blood Pressure, and Low-Density Lipoprotein

Abstract

Objectives: To compare a 90-day-supply and a less than 90-day-supply of medication on adherence to refilling prescriptions and clinical biomarkers for hemoglobin A1c (HbA1c), blood pressure (BP), and low-density lipoprotein (LDL). Methods: A retrospective chart review was completed for a cohort of patients prescribed an oral hypoglycemic agent (OHA), angiotensin-converting enzyme inhibitor (ACEI), or angiotensin II receptor blocker (ARB), and/or a statin. Data were categorized into 90-day-supply and less than 90-day-supply and on the minimum value for control determined by the CMS Star Ratings system. Adherence was defined by the Health Plan Quality Improvement Department as ≥ 85% of days covered. Clinical biomarker cutoffs were HbA1c (<9% or ≥ 9%), BP (Systolic BP ≤ 140 mm Hg and >140 mm Hg or Diastolic BP ≥ 90 mm Hg regardless of SBP), and LDL (<100 mg/dl or ≥100 mg/dl). Results: The analysis included 251 patients: 159 females (mean 64.9 ± 11.7 years) and 92 males (mean 61.5 ± 11.3 years). Patients with medications from multiple classes were included in more than one analysis. Adherence was statistically in favor of the 90-day-supply compared to less than 90-day-supply for all three classes of drugs. The clinical biomarkers were statistically not different for each drug group. Conclusion: A 90-day-supply was statistically greater than a less than 90-day-supply for CMS Star Ratings metrics, but was not statistically significant for clinical biomarkers for HbA1c, SBP, and LDL.