Estimating Medication Adherence from Electronic Health Records Using Rolling Averages of Single Refill-based Estimates

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract / Description of output

Medication adherence is usually defined as the manner in which a patient takes their medication, in relation to the regimen agreed to with their healthcare provider. Electronic Health Records (EHRs) can be used to estimate adherence in a cost-effective and non-invasive manner across large-scale populations, although there is no universally agreed optimal approach to doing so. We sought to explore patterns of asthma ICS prescription refills in a large EHR dataset, and to evaluate the use of rolling-average based measures towards short-term adherence estimation. Over 1.6 million asthma controllers were prescribed for our cohort of 91,332 individuals, between January 2009 and March 2017. The Continuous Single interval measures of medication Availability (CSA) and Gaps (CSG) were calculated for individual prescriptions, as well as rolling-average adherence measures of the CSA over 3, 5, or 10 past prescription intervals. 16.7% of the study population had only a single prescription during their follow-up (a median duration of 7.1 years). 51% of prescriptions were refilled before (or on the day that) supply was exhausted, and for 19% of prescription refills, the amount of medication dispensed should have lasted at least twice as long as the duration before the next refill was filled. The rolling average measures had statistically strong associations (Spearman |R|>0.7) with the estimate for the subsequent prescription refill. Rolling averages of multiple individual refill-level adherence estimates provide a novel and simple way to crudely smoothen estimates from individual prescription refills, which are strongly influenced by common (and adherent) real-world behaviors, for more meaningful and effective trend detection.

Original languageEnglish
Title of host publication44th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2022
PublisherInstitute of Electrical and Electronics Engineers Inc.
Pages3554-3557
Number of pages4
ISBN (Electronic)9781728127828
DOIs
Publication statusPublished - 1 Jul 2022
Event44th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2022 - Glasgow, United Kingdom
Duration: 11 Jul 202215 Jul 2022

Publication series

NameProceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS
Volume2022-July
ISSN (Print)1557-170X

Conference

Conference44th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2022
Country/TerritoryUnited Kingdom
CityGlasgow
Period11/07/2215/07/22

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