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High rates of medication adherence in patients with pulmonary arterial hypertension: An integrated specialty pharmacy approach

Phosphodiesterase-5 inhibitors (PDE-5I) have demonstrated improvement in disease symptoms and quality of life for patients with pulmonary arterial hypertension (PAH). Despite these benefits, reported adherence to PDE-5I therapy is sub-optimal. Clinical pharmacists at an integrated practice site are...

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Autores principales: Shah, Nisha B., Mitchell, Rhonita E., Proctor, Stephanie Terry, Choi, Leena, DeClercq, Joshua, Jolly, Jacob A., Hemnes, Anna R., Zuckerman, Autumn D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6553732/
https://www.ncbi.nlm.nih.gov/pubmed/31170217
http://dx.doi.org/10.1371/journal.pone.0217798
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author Shah, Nisha B.
Mitchell, Rhonita E.
Proctor, Stephanie Terry
Choi, Leena
DeClercq, Joshua
Jolly, Jacob A.
Hemnes, Anna R.
Zuckerman, Autumn D.
author_facet Shah, Nisha B.
Mitchell, Rhonita E.
Proctor, Stephanie Terry
Choi, Leena
DeClercq, Joshua
Jolly, Jacob A.
Hemnes, Anna R.
Zuckerman, Autumn D.
author_sort Shah, Nisha B.
collection PubMed
description Phosphodiesterase-5 inhibitors (PDE-5I) have demonstrated improvement in disease symptoms and quality of life for patients with pulmonary arterial hypertension (PAH). Despite these benefits, reported adherence to PDE-5I therapy is sub-optimal. Clinical pharmacists at an integrated practice site are in a unique position to mitigate barriers related to PAH therapy including medication adherence and costs. The primary objective of this study was to assess medication adherence to PDE-5I therapy within an integrated care model at an academic institution. The secondary objective was to assess the impact of out-of-pocket (OOP) cost, frequency of dosing, adverse events (AE) and PAH-related hospitalizations on medication adherence. We performed a retrospective cohort analysis of adult patients with PAH who were prescribed PDE-5I therapy by the center’s outpatient pulmonary clinic and who received medication management through the center’s specialty pharmacy. We defined optimal medication adherence as proportion of days covered (PDC) ≥ 80%. Clinical data including AEs and PAH-related hospitalizations were extracted from the electronic medical record, and financial data from pharmacy claims. Of the 131 patients meeting inclusion criteria, 94% achieved optimal adherence of ≥ 80% PDC. In this study population, 47% of patients experienced an AE and 27% had at least one hospitalization. The median monthly OOP cost was $0.62. Patients with PDC<80% were more likely to report an AE compared to patients with PDC≥ 80% (p = 0.002). Hospitalization, OOP cost, and frequency of dosing were not associated with adherence in this cohort. Patients receiving PDE-5I therapy through an integrated model achieved high adherence rates and low OOP costs.
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spelling pubmed-65537322019-06-17 High rates of medication adherence in patients with pulmonary arterial hypertension: An integrated specialty pharmacy approach Shah, Nisha B. Mitchell, Rhonita E. Proctor, Stephanie Terry Choi, Leena DeClercq, Joshua Jolly, Jacob A. Hemnes, Anna R. Zuckerman, Autumn D. PLoS One Research Article Phosphodiesterase-5 inhibitors (PDE-5I) have demonstrated improvement in disease symptoms and quality of life for patients with pulmonary arterial hypertension (PAH). Despite these benefits, reported adherence to PDE-5I therapy is sub-optimal. Clinical pharmacists at an integrated practice site are in a unique position to mitigate barriers related to PAH therapy including medication adherence and costs. The primary objective of this study was to assess medication adherence to PDE-5I therapy within an integrated care model at an academic institution. The secondary objective was to assess the impact of out-of-pocket (OOP) cost, frequency of dosing, adverse events (AE) and PAH-related hospitalizations on medication adherence. We performed a retrospective cohort analysis of adult patients with PAH who were prescribed PDE-5I therapy by the center’s outpatient pulmonary clinic and who received medication management through the center’s specialty pharmacy. We defined optimal medication adherence as proportion of days covered (PDC) ≥ 80%. Clinical data including AEs and PAH-related hospitalizations were extracted from the electronic medical record, and financial data from pharmacy claims. Of the 131 patients meeting inclusion criteria, 94% achieved optimal adherence of ≥ 80% PDC. In this study population, 47% of patients experienced an AE and 27% had at least one hospitalization. The median monthly OOP cost was $0.62. Patients with PDC<80% were more likely to report an AE compared to patients with PDC≥ 80% (p = 0.002). Hospitalization, OOP cost, and frequency of dosing were not associated with adherence in this cohort. Patients receiving PDE-5I therapy through an integrated model achieved high adherence rates and low OOP costs. Public Library of Science 2019-06-06 /pmc/articles/PMC6553732/ /pubmed/31170217 http://dx.doi.org/10.1371/journal.pone.0217798 Text en © 2019 Shah et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Shah, Nisha B.
Mitchell, Rhonita E.
Proctor, Stephanie Terry
Choi, Leena
DeClercq, Joshua
Jolly, Jacob A.
Hemnes, Anna R.
Zuckerman, Autumn D.
High rates of medication adherence in patients with pulmonary arterial hypertension: An integrated specialty pharmacy approach
title High rates of medication adherence in patients with pulmonary arterial hypertension: An integrated specialty pharmacy approach
title_full High rates of medication adherence in patients with pulmonary arterial hypertension: An integrated specialty pharmacy approach
title_fullStr High rates of medication adherence in patients with pulmonary arterial hypertension: An integrated specialty pharmacy approach
title_full_unstemmed High rates of medication adherence in patients with pulmonary arterial hypertension: An integrated specialty pharmacy approach
title_short High rates of medication adherence in patients with pulmonary arterial hypertension: An integrated specialty pharmacy approach
title_sort high rates of medication adherence in patients with pulmonary arterial hypertension: an integrated specialty pharmacy approach
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6553732/
https://www.ncbi.nlm.nih.gov/pubmed/31170217
http://dx.doi.org/10.1371/journal.pone.0217798
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