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See Latest ArticlesGood and poor adherence: optimal cut-point for adherence measures using administrative claims data
Current Medical Research and Opinion, 08/18/09
Karve S et al. – This study provided an initial empirical basis for selecting 0.80 as a reasonable cut–off point that stratifies adherent and non–adherent patients based on predicting subsequent hospitalization across several highly prevalent chronic diseases. This cut–off point has been widely used in previous research and this findings suggest that it may be valid in these conditions; it is based on a single outcome measure, and additional research using these methods to identify adherence thresholds using other outcome metrics such as laboratory or physiologic measures, which may be more strongly related to adherence, is warranted.
Bradley C. Martin, 08/18/09
| The medical possession ratio (MPR) is a continuous measure to assess patient adherence to chronic medications, however, a valid cut point to stratify good compliers from poor compliers has not been validly determined for many therapies. This study found that for persons with schizophrenia, diabetes, hypertension, or hyperlipidemia, a cut point at or near 0.80 or 80% is the most predictive point to stratify patients with regard to subsequent hospitalization risk. The optimal cut point for persons with congestive heart failure was near 0.60. It is fortunate that the evidence to support the notion that persons who take 80% of their medications as measured by the MPR are good compliers, at least using hospitalization as an outcome measure, matches what persons have long been doing without much empirical support for that cut point. There are many factors that influence hospitalization rates, and though adherence does predict subsequent hospitalization, it is only a modest predictor by itself. Additional research is warranted using other outcome measures to confirm these findings. |
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