Physician perception of patient adherence compared to patient adherence of osteoporosis medications from pharmacy claims

Abstract

Objective:

This study explored physicians’ perceptions of patient adherence to medications compared with patient adherence derived by administrative data in the treatment of osteoporosis.

Research design and methods:

A study involving written questionnaires from prescribers treating patients with postmenopausal osteoporosis (PMO) compared the questionnaire responses to pharmacy claims of these prescribers’ patients’ refill patterns. Approximately 2000 physicians from a large US health plan were faxed or mailed a survey. Data from the physician survey were merged with administrative claims data of the participating physicians’ patients.

Results:

A total of 412 physicians (21.8%) responded. Although a low response rate, there were no significant demographic differences between participating and non-participating physicians. Surveyed physicians reported that 66% of their patients had private/commercial coverage and over 60% reported seeing their PMO patients annually. Overall, physicians estimated that 69.2% of patients were adherent 80% of the time after 12 months of therapy. Yet, pharmacy claims data for those physicians’ patients indicated 48.7% of patients were adherent (defined as having an MPR of ≥80%) after 12 months of therapy. Physicians overestimated their patients’ adherence regardless of medication class and across physician specialties. Regression modeling revealed that physicians who have been in practice longer estimated fewer patients as adherent, whereas those who prescribe more PMO treatments estimate a greater number of patients as adherent. Providers cited side effects and affordability of medication as the most frequent reasons for non-adherence.

Conclusions:

Physicians overestimate patient adherence to PMO therapies. Improving physician awareness of medication non-adherence to PMO therapies may facilitate physician–patient dialogue, with the aim of identifying patient-centered reasons for non-adherence. These discussions are important because patients with poorer adherence have a higher risk of fracture. Future research should focus on reasons for patient non-adherence to osteoporosis regimens and intervention strategies that improve communication between the provider and patient. Findings must be considered within the limitations of this claims database analysis. Some degree of incomplete or incorrect coding may exist, and the presence of a claim for a filled prescription does not indicate that the medication was consumed or taken as prescribed. Patients included in the study are not necessarily representative of all patients being treated for osteoporosis.

Key words::

• Data collection
• Medication adherence
• Osteoporosis
• Physicians
• Postmenopausal
• Survey

Transparency

Declaration of funding

This study was funded by Amgen, Inc.

Declaration of financial/other relationships

R.C., P.B. and V.Z. have disclosed that they are employees of i3 Innovus, which received grant support from Amgen. S.I. and D.M. have disclosed that they are employees of, and are stockholders of, Amgen. L.K. was involved in the analysis and writing of the study and serves as a consultant to Amgen.

Some peer reviewers receive honoraria from CMRO for their review work. The peer reviewers of this paper have disclosed that they have no relevant financial relationships.

Acknowledgment

The authors thank Victoria Porter and Jesse Potash for their assistance with the preparation of this manuscript.

This study was presented in poster form at the Academy of Managed Care Pharmacy 2009 Educational Conference, October 7–9, 2009, San Antonio, TX, USA. ‘Copher R, Buzinec P, Iqbal SU, Macarios D, Zarotsky V. Physician survey of patient adherence to osteoporosis medications.’