Guest blog post by Avella Specialty Pharmacy
Given that one in three patients don’t fill prescriptions as directed, medication adherence is a problem across all patient populations.1 Lack of adherence can be caused by a variety of factors, including physical/mental, social, perceptual and logistical barriers. Among these barriers, forgetfulness is a major challenge…and yet largely preventable.
Patients with HIV are especially at-risk for troubling repercussions that may result from medication non-adherence. Lack of adherence to antiretroviral therapy (ART) can lead to drug resistance over time. This in turn limits future treatment options and negatively impacts outcomes.
A recently-conducted retrospective evaluation investigated this issue, specifically to assess whether providing HIV patients with access to refill and medication reminders via a mobile app would lead to improved medication adherence. The study was conducted by Avella Specialty Pharmacy in cooperation with mscripts, a mobile health provider.
An overview of the study methodology
All 2,120 participating patients included in the retrospective review were taking a single or co-formulated antiretroviral drug (ARV) such as Isentress®, Trizivir®, and Truvada®.
Data for the analysis was derived from two sources:
- Avella provided data from its own patient records for 1,896 customers who met the analysis criteria and who had not downloaded the mscripts app
- mscripts used its database sourced from the pharmacy management dispensing system for 224 Avella customers that met the analysis criteria and who had downloaded the mscripts app as of December 2014
The analysis criteria included:
- An mscripts app registration data prior to 180 days from the last day of the most recent fill plus days’ supply for those who had downloaded the mscripts app
- A fill date existed prior to the 180 days from the last day of the most recent fill plus days’ supply
- At least one 30-day supply fill existed within 180 days from the last day of the most recent fill plus days’ supply
Patients were grouped into on-platform users (those who opted in to enroll in the app) and off-platform users (patients not using the app). 10.6% of the total study population were on-platform users and 89.4% of the population were off-platform users for the control group.
On-platform users were provided with a variety of options for reminder functionality. This chart depicts which notification methods were selected by users in the on-platform group.
After the six-month study period assessed retrospectively concluded, analysis revealed impressive results across a variety of factors—overall improved adherence rates and the proportion of users that achieved 90% adherence (key to viral suppression) as well as patient satisfaction. A sampling of the results follows:
- HIV patients were 2.9 times more likely to be adherent when using the mobile app.
- On-platform and off-platform patients had significantly different persistence curves – likelihood of discontinuing or continuing to refill their prescription for brand-name ARVs – and a lower proportion of on-platform patients discontinued medication refills compared to off-platform patients (4.5% vs. 12.6%).
- Compared to the US HIV population, app users on ART at Avella Specialty Pharmacy had a 49% higher adherence rate, as depicted by the graphic below.
For more insights gained through this retrospective analysis, or to learn more about the mobile app rollout (including marketing, patient privacy and education efforts used to encourage app usage) view the entire analysis here.
This is a sponsored blog posting, written and paid for by Avella Specialty Pharmacy specifically for tHEORetically Speaking blog.
1. Tamblyn, Robyn, et al. Incidence and Determinants of Primary Nonadherence with prescribed medication in Primary Care. Annals of Internal Medicine. April, 2014.