Medication Management Services Could Increase Adherence in Transplant Patients


Renal transplant recipients eligible for medication management services under Medicare Part D had higher adherence to medication than ineligible patients.

A recent study found that access to medication management (MTM) services increased adherence to immunosuppressant therapy (IST) in renal transplant recipients (RTR) with Medicare Part D.

IST adherence is critical for graft survival in RTR patients, however, rates of nonadherence can range from 20 to 40%.

Researchers conducted cross-sectional analyses on claims data from Medicare Parts A, B, and D, as well as follow-up data reported to the United Network for Organ Sharing database in the United States Renal Data System.

According to the study published in Patient Preference and Adherence, researchers included 17,181 adult RTRs who received a transplant between 2001 and 2006, had graft survival for 12 months, were covered under Part D, and were prescribed tacrolimus.

Adherence was based on Parts B and D prescription claims data and measured by medical possession ratio.

At 12 months, researchers found that RTRs eligible for MTM were 1.14 times more likely to adhere to medication compared with ineligible RTRs.

Researchers said that their results support the premise of MTM: medication reviews, development of medication-related action plans, follow-ups, and other medication management services, will result in better overall adherence that is more cost-effective and leads to better health outcomes.

Though MTM was seen to increase adherence, less than half of RTRs in the study were eligible for the services under Part D.

Other variables that affected adherence were the number of prescription drugs, sex, and age, the researchers wrote. RTRs taking a large number of prescription drugs were more likely to be adherent due to an established regimen.

Researchers suggest that males and older adults may need more adherence support in the first year post-transplant.

Researchers concluded that because RTRs eligible for MTM under Medicare Part D had increased adherence and less than half of patients were eligible, the US Centers for Medicare & Medicaid Services should reconsider increasing access to MTM for these patients.

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