Patient-tailored interventions improve specialty medication adherence

Patient-tailored interventions have led to significant improvements in adherence to specialty medications when compared with standard of care, according to a study.

A team of investigators conducted a pragmatic, randomized controlled trial at a single-centre health-system specialty pharmacy from May 2019 to August 2021. They included recently nonadherent patients prescribed self-administered specialty medications from several specialty clinics.

Eligible patients were stratified by historical clinic rates of nonadherence and randomized to either usual care or intervention arms. Those in the intervention arm received patient-tailored care and 8 months of follow-up. The investigators used a Wilcoxon test to analyse the difference in 6-, 8-, and 12-month postenrollment adherence, calculated using proportion of days covered between the two groups.

A total of 438 patients (median age 54 years, 68 percent women, 82 percent White) were included in the trial, and both arms had similar baseline characteristics.

Memory (37 percent) and unreachability (28 percent) were the most common reasons for nonadherence in the intervention group.

A significant difference was noted in median proportion of days covered between patients in the usual care and intervention arms at 8 months (0.88 vs 0.94; p<0.001), 6 months (0.90 vs 0.95; p=0.003), and 12 months postenrollment (0.87 vs 0.93; p<0.001).

“Specialty pharmacies should consider targeting nonadherent patients for adherence interventions,” said the investigators, noting that nonadherence often resulted in poor clinical outcomes and increased costs.