Patient Activation to Reduce Cardiovascular Risk 4.4.08

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Leonard Davis Institute of Health Economics

Author: Barbara Turner

Health & Medicine

PATIENT ACTIVATION TO REDUCE CARDIOVASCULAR RISK: IS FAILING TO FILL LIPID-LOWERING DRUG PRESCRIPTIONS AT THE PHARMACY ASSOCIATED WITH FAILING TO FILL ANTIHYPERTENSIVE DRUG PRESCRIPTIONS? 1 Turner B.J., 1 Eachus S., 1 Weiner M.G., 2 Fox S., 3 Roberts C. 1 University of Pennsylvania, Philadelphia, PA; 2 Keystone/AmeriHealth Mercy Health Plan, Philadelphia, PA; 3 Pfizer Global Pharmaceuticals, New York, NY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Reference categories: *50<Age<70, **White Race, ***lowest quartile BP meds, ‡ normal BP at last visit, ‡ ‡ lower half of visit adherence, † optimal LDL or < 30 points above target, † † 100% adherence to LLM scripts Table 1 Selected Study Characteristics ,[object Object],[object Object],[object Object],Age* >=70 18-50 Race** Non Black Number of HTN meds in regimen (quartile)*** 2 3 4 Most recent BP ‡ Stage 2 Stage 1 Related comorbidities Per comorbidity Adherence to visits ‡ ‡ LLM filling behavior † † None Lowest tertile Middle tertile Highest tertile LDL Level † >60 points above target >30 points above target Figure 1: Adjusted Odds of Filling n AHM Prescription Above median A key first step in preventing cardiovascular (CV) disease occurs when the patient fills a prescription for an antihypertensive medication (AHM) at the pharmacy. Background ,[object Object],[object Object],Hypotheses ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Methods Results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Conclusions Clinical Implications Methods Characteristic Patients AHM Prescriptions Total 514 (100) 4,665 (100) Women (%) 379 (73.7) 3,714 (79.6) Black race (%) 437 (85.0) 4,133 (88.6) Related comorbidities (mean, SD) 1.28 (1.01) 1.22 (0.99) Unrelated comorbidities (mean, SD) 2.73 (2.09) 2.53 (2.01) Primary care visit adherence Below median Above median 149 (29.0) 365 (71.0) 1227 (26.3) 3438 (73.7) AHM Rxes per patient (mean) 16.3 (10.1) NA % AHMs filled NA 3,267 (70.0) LDL level (per NCEP Normal High Very High (<190) 228 (44.4) 257 (50.0) 29 (5.6) 1947 (41.7) 2523 (54.1) 195 (4.2) LLM Rxes per patient (mean, SD) 4.88 (4.12) NA % LLM filled (mean, SD) 57.6 (38.1) NA Results

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