Novel Methodology to Measure Adherence to Complex Medication Regimens in HIV/AIDS PatientsThe objective of the study was to design a new multi-drug adherence metric that takes into account the evolving therapeutic regimen of HIV/AIDS patients. These patients typically take an array of antiretroviral drugs that is referred to as highly active antiretroviral therapy (HAART). It is not uncommon for a patient to develop an issue with their HAART regimen (e.g., resistant HIV and/or side effects) which requires changes to the therapy (i.e., adjustment in drugs and/or dosages). To achieve the best possible outcome, patients must strictly adherence to their HAART. It is important to identify non-adherent patients so that health care providers can intervene where appropriate. The traditional measurement of adherence – Medication Possession Ratio (MPR) – may not accurately capture the adherence rate for HIV/AIDS patients due to drug switching. The study included patients 18 years of age or older who had received prescriptions for two or more HIV drugs or at least one combination HIV drug during a six-month period. Prescription claims of these patients for the subsequent 180 days (from March 4, 2009 through August 31, 2009) were then evaluated to determine adherence rates. The patient-level MPR was calculated by aggregating the MPR for each drug the patient was taking. The Medication Adherence Rate (MAR) was also calculated for each patient. The MAR is comparable to the MPR, but the MAR takes into account medication switching by combining the day supply for the discontinued and new drugs. Based on the results, the traditional MPR tended to underestimate adherence for patients having to switch drugs because the metric does not fully account for the additional day supply of the newly added drug. The MAR better represents adherence for complex and dynamic medication regimens thereby providing a more accurate bases for identifying low-adherence patients for pharmacist intervention. M. Khalid1, R. Levine1, L. Castle1, M. Cassler1, L. Nichols1, M. Bruno2 and JK Taylor2 Based on a study by the Medco Research InstituteTM and Pfizer, Inc., presented at the 2010 annual meeting of the Academy of Managed Care Pharmacy 1Medco Health Solutions, Inc., Franklin Lakes, NJ |