- Jason Cooper: Accordant Health Services, a CVS Caremark Company, Greensboro, North Carolina 27407, USA. Jason.Cooper@caremark.com
Several studies have shown that poor adherence to pharmaceutical treatment regimens increases health condition severity, mortality rates, and overall health care costs. The dimension of medication adherence in health management outcomes has been deficient of a comprehensive yet practical standardized measurement methodology. DMAA: The Care Continuum Alliance, along with its industry partners, noted this absence and assembled a clinical workgroup to undertake an appropriate standardization effort. The medication adherence clinical workgroup within DMAA's outcomes measurement and methodology steering committee convened in February 2008 to review literature, incorporate subject matter expertise, gain consensus on measurement techniques, and discuss known limitations. This workgroup has successfully completed a standardized methodology to measure medication adherence rates via medication possession ratio (MPR). The guidelines for this method were approved for inclusion in Volume III of DMAA's Outcomes Guidelines Report. Accordant Health Services, as a member of this workgroup, volunteered to test the recommended specification and measure. These tests would encompass not only measurement calculations but also feasibility considerations. The measurement period for these tests was the 2007 calendar year. Results showed that condition-specific MPRs for a health plan population ranged between 78.9% and 83.6%. The same methods applied to an employer group population revealed a condition-specific MPR range of 75.4% to 76.5%. Based on 2007 book of business data for CVS Caremark's Adherence to Drug Therapy program, those results are within the 95% confidence interval for employer group and health plan populations.