Development of a graphical tool to measure medication adherence in asthma patients: A mixed-methods pilot study

ABSTRACT

Objectives: (1) To develop Med-Resp, a graphical tool based on prescription refills to measure adherence and use of asthma medications; (2) To test the feasibility of implementing Med-Resp in a hospital outpatient asthma clinic; (3) To explore the effectiveness of Med-Resp to improve medication adherence to asthma controller medications. Methods: A sequential exploratory design was used: (1) Prototype design in collaboration with respiratory physicians and patients via focus groups; (2) Med-Resp creation based on algorithms developed and applied to prescription refills data recorded in the drug claims database reMed; (3) Feasibility assessment of the implementation of Med-Resp in the outpatient asthma clinic; and (4) Exploration of the effectiveness of Med-Resp through a pre-post design. Results: A total of 29 patients and six respiratory physicians participated in this pilot study. The tool was highly appreciated by the participants, while the majority believed that Med-Resp has the potential to enhance physician-patient communication and aid in treatment decisions. The feasibility of implementing Med-Resp in clinical practice was demonstrated. However, we did not observe an increase in medication adherence in the six months following its implementation. Conclusion: In the clinical setting, the use of prescription refills data may constitute a non-invasive and objective measure of medication adherence. This study highlights the importance of providing clinicians with objective and easily interpretable measures of medication adherence and use in routine clinical practice. Med-Resp has the potential to become implemented on a larger scale if integrated in electronic medical records.

KEYWORDS:

• Control/Management
• epidemiology
• treatment

Acknowledgements

We would like to thank Matthew Masapollo, Tuo Liu, and Catherine Dalal for the diligent proof-reading and editing of this manuscript.

Declaration of interest

LB has received research grants and professional fees from AstraZeneca, GlaxoSmithKline, Pfizer, and Genentech for studies unrelated to this article. AY received scholarships from the Drug Safety and Effectiveness Crossdisciplinary training program and the respiratory health network of the Fonds de recherche du Québec-Santé (FRQ-S).

Author contributions

LB, AY, CL, AC designed the study and wrote the manuscript. LB and CL acquired the funding. LB, AY, AF contributed to data analyses. AY, CL, AC, AF, and LB interpreted the data, revised the manuscript, had access to complete study data, and had authority over manuscript preparation as well as approval of the final version and the decision to submit for publication.

Additional information

Funding

This study was funded by an investigator-initiated study grant from Novartis. RESP is funded by the Réseau québécois de recherche sur les médicaments (RQRM)/FRQ-S, the Canadian Insititute for Health Research, the Fondation de l'Hôpital du Sacré-Coeur de Montréal, Merck Frosst Canada Inc, and Novartis Canada Ltd. Study sponsors had no role in the design of the database and data collection.