Synchronized Medication Refills Improve Outcomes in Patients with Diabetes

New study results suggest that synchronized medication refills could potentially improve health outcomes in patients with diabetes.

Patients with diabetes, who frequently present with several comorbidities, often require complicated treatment regimens that make adherence difficult. Medication synchronization (the process of standardizing complex medication refill schedules) presents as a potential mechanism to both improve adherence rates and cut health care costs. To better understand the effect of these synchronized drug refill schedules on those suffering from diabetes, the present study authors assessed the relationship between medication synchronization and adherence, health care resource usage, and health care expenditures in patient with diabetes. The results of the study are to be presented at AMCP Nexus 2019.

The retrospective, cohort study evaluated the differences in diabetes medication adherence, inpatient admissions, and the total health care costs between patients using medication synchronization and propensity-score matched controls. These data were extracted from the 2015-2018 Truven MarketScan Research Databases, from which the subjects eligible for inclusion in the Pharmacy Quality Alliance (PQA) diabetes medication (excluding insulin) adherence measure were identified. Patients using two or more diabetes, statin, or renin-angiotensin system antagonist drug classes were included in this study.

Conditional logistic regression was leveraged to analyze the correlation between medication adherence and synchronization, and generalized linear mixed models with log link and gamma distribution (expenditures) or negative binomial distribution (utilization) were used to evaluate economic outcomes. Odds ratios (OR), rate ratios (RR), and cost ratios (CR) were estimated from the data as well.

A total of 20,325 medication synchronization cases successfully met inclusion criteria and were matched to controls. The researchers found that commercial cases (n=16,136) had greater adherence (67.7% vs. 57.4% [OR=1.67; 95% CI, 1.59 to 1.75]), fewer hospital admissions (RR=0.59; 95% CI, 0.53 to 0.67), and lower median health care expenditures ($3,687 vs. $7,480 [CR=0.61; 95% CI=0.57 to 0.65]) than their matched control. It was also found that Medicare supplemental cases (n=4,189) had greater adherence (86.5% vs. 70.4% [OR=2.96; 95% CI, 2.62 to 3.35]), fewer hospital admissions (RR=0.72; 95% CI 0.63 to 0.82), and lower median health care expenditures ($7,353 vs. $10,592 [CR=0.69; 95% CI, 0.64 to 0.75]) than the controls as well.

Medication synchronization was associated with higher adherence, lower inpatient utilization, and lower health care costs,” the authors wrote. “Medication synchronization may facilitate improved health outcomes across various populations.”

This work was sponsored by Merck Sharp & Dohme.

 

Meeting Abstract:

 Nsiah I, Pickering M, et al. Associations of Medication Synchronization: A Propensity Score-Matched Diabetes Cohort Study Evaluating Adherence, Healthcare Resource Utilization, and Expenditures. Presented at: AMCP Nexus 2019; October 29 – Nov 1; National Harbor, MD.