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Patient-Centered Medical Homes Linked to Improved Medication Adherence
According to a recent study in the Annals of Internal Medicine, patients who receive care through patient-centered medical homes (PCMHs) for common high-cost chronic diseases had higher rates of medication adherence.
“Because poor medication adherence is strongly associated with worse patient outcomes and high health care spending, it is viewed as a key measure of quality of care by major organizations,” Julie C Lauffenburger, PharmD, PhD, of the department of pharmacoepidemiology and pharmacoeconomics at Brigham and Women’s Hospital, and colleagues wrote. “However, it has not been evaluated in primary care practices that meet recognition criteria for PCMHs.”
The researchers conducted a retrospective cohort study with participants initiating therapy with common medications for chronic diseases including diabetes, hypertension, and hyperlipidemia between 2011 and 2013. Researchers tracked medication over 12 months following treatment initiation and compared the data against patients who were cared for by providers practicing in National Committee for Quality Assurance. Researchers used linear mixed models to examine to association between medical homes and patient adherence.
According to the results of the study, 18,611 of the 313,765 participants who met the study criteria received care through PCHMs. Researchers found that the average adherence rate among medical home participants was 64%, and among control participants was 59%. Further data released show among 4660 matched control and medical home practices, the average rate of medication adherence was significantly higher in medical homes, 2.2%. The association between overall better adherence and medical homes did not differ by the studied diseases, including diabetes (3.0%), hypertension (3.2%), and hyperlipidemia (1.5%).
“Receipt of care in a patient-centered medical home is associated with better adherence, a vital measure of health care quality, among patients initiating treatment with medications for common high-cost chronic diseases,” Dr Lauffenburger and colleagues concluded. “These findings have significant implications for providers, health plans, and policymakers who are considering the best potential practices for patients.”
In an accompanying editorial, Michele Heisler, MD, MPH, professor of internal medicine at the University of Michigan, lauded the research by Dr Lauffenburger and colleagues, noting that “patient-centered medical home initiatives are highly heterogeneous, and some designs and approaches will be more successful than others. Adherence is a complex phenomenon; effective approaches must be tailored to meet individual patients' needs and preferences.”
—Julie Gould
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