Feasibility of Implementing a Web-based Tool Built from Pharmacy Claims
Data (e-MEDRESP) to Monitor Adherence to Respiratory Medications in
Objectives: e-MEDRESP is a novel web-based tool that provides easily
interpretable information on patient adherence to asthma/chronic
obstructive pulmonary disease medications, using pharmacy claims data.
This study investigated the feasibility of implementing e-MEDRESP in
primary care. Materials and Methods: In this 16-month prospective cohort
study, e-MEDRESP was integrated into electronic medical records.
Nineteen family physicians and 346 of their patients were enrolled.
Counters embedded in the tool tracked physician use during the
follow-up. Patient/physician satisfaction with e-MEDRESP was evaluated
though telephone interviews and online questionnaires. The capacity of
e-MEDRESP to improve adherence was explored using a pre–post analysis.
Results: Overall, 252 patients had at least one medical visit during
follow-up. e-MEDRESP was consulted by 15 (79%) physicians for 85 (34%)
patients during clinic visits. Seventy-three patients participated in
telephone interviews; 84% reported discussing their medication use with
their physician; 33% viewed their e-MEDRESP report and indicated that
it was easy to interpret. The physicians reported that the tool
facilitated their evaluation of their patients’ medication adherence
(mean ± standard deviation rating: 4.8 ± 0.7, on a 5-point Likert
scale). Although the pre–post analysis did not reveal improved
adherence in the overall cohort, adherence improved significantly in
patients whose adherence level was <80% and patients
prescribed inhaled corticosteroids (26.9% [95% CI 14.3%–39.3%])
or long-acting muscarinic agents (26.4% [95% CI 12.4%–40.2%]).
Conclusions: e-MEDRESP was successfully integrated in clinical practice.
It could serve as a powerful tool to help physicians monitor their
patients’ medication adherence.