(B-178) Accessing the Effectiveness of a Telephonic Medication Adherence Program among Medicare Members

Background: Intervention programs using phone calls and/or text messages to remind prompt medication refills and address adherence barriers have been commonly used among Medicare members. However, because the target population, intervention reasons and program design vary across programs, knowledge is limited about the effectiveness of these programs and factors that make these programs effective.

Objectives: to (1) access the effectiveness of a telephonic intervention program that intends to increase medication refills among Medicare members with adherence risk and (2) predict medication refills among Medicare members enrolled in the telephonic intervention program.

Methods: Medicare members from a PBM who were taking antihypertensive, antidiabetic or antihyperlipidemic medications and considered having adherence risk were selected for a telephonic medication adherence intervention program. Participants received telephonic refill reminders and information from pharmacists or pharmacy technicians about extended-day supply, home delivery and other solutions to medication adherence barriers. Claims in the past 12 months were reviewed to count refills within 28 days from the date of calling as outcome variable. Participants’ demographics, socioeconomic status, medical diagnoses and medication history were included in a logistic regression model. The trained model was then used to predict the participants’ future responses to the intervention.

Results: A total of 237,380 Medicare members were included (145,125 high-cholesterol patients, 52,119 diabetes patients and 111,307 hypertension patients respectively). The logistic regression model was able to predict refills with an area under of the ROC curve of 72%. Age, medical diagnoses, medication days of supply, intervention reason and adherence in previous years are strong predictors. Using a prediction threshold equivalent to the refill rate among model training sample, the model predicted a refill rate of 40% among program participants.

Conclusions: A logistic regression model identified the critical factors associated with the effectiveness of a telephonic medication adherence intervention program. Future medication adherence interventions should consider participants’ medication regimen, medication history and adherence barriers to be effective.