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

Nisha B Shah, Rhonita E Mitchell, Stephanie Terry Proctor, Leena Choi, Joshua DeClercq, Jacob A Jolly, Anna R Hemnes and Autumn D Zuckerman

PLOS ONE, 2019, vol. 14, issue 6, 1-12

Abstract: 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

Date: 2019
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0217798

DOI: 10.1371/journal.pone.0217798

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