Novel application of approaches to predicting medication adherence using medical claims data.

dc.contributor.author

Zullig, Leah L

dc.contributor.author

Jazowski, Shelley A

dc.contributor.author

Wang, Tracy Y

dc.contributor.author

Hellkamp, Anne

dc.contributor.author

Wojdyla, Daniel

dc.contributor.author

Thomas, Laine

dc.contributor.author

Egbuonu-Davis, Lisa

dc.contributor.author

Beal, Anne

dc.contributor.author

Bosworth, Hayden B

dc.date.accessioned

2023-08-09T17:12:22Z

dc.date.available

2023-08-09T17:12:22Z

dc.date.issued

2019-12

dc.date.updated

2023-08-09T17:12:22Z

dc.description.abstract

Objective

To compare predictive analytic approaches to characterize medication nonadherence and determine under which circumstances each method may be best applied.

Data sources/study setting

Medicare Parts A, B, and D claims from 2007 to 2013.

Study design

We evaluated three statistical techniques to predict statin adherence (proportion of days covered [PDC ≥ 80 percent]) in the year following discharge: standard logistic regression with backward selection of covariates, least absolute shrinkage and selection operator (LASSO), and random forest. We used the C-index to assess model discrimination and decile plots comparing predicted values to observed event rates to evaluate model performance.

Data extraction

We identified 11 969 beneficiaries with an acute myocardial infarction (MI)-related admission from 2007 to 2012, who filled a statin prescription at, or shortly after, discharge.

Principal findings

In all models, prior statin use was the most important predictor of future adherence (OR = 3.65, 95% CI: 3.34-3.98; OR = 3.55). Although the LASSO regression model selected nearly 90 percent of all candidate predictors, all three analytic approaches had moderate discrimination (C-index ranging from 0.664 to 0.673).

Conclusions

Although none of the models emerged as clearly superior, predictive analytics could proactively determine which patients are at risk of nonadherence, thus allowing for timely engagement in adherence-improving interventions.
dc.identifier.issn

0017-9124

dc.identifier.issn

1475-6773

dc.identifier.uri

https://hdl.handle.net/10161/28703

dc.language

eng

dc.publisher

Wiley

dc.relation.ispartof

Health services research

dc.relation.isversionof

10.1111/1475-6773.13200

dc.subject

Humans

dc.subject

Myocardial Infarction

dc.subject

Hydroxymethylglutaryl-CoA Reductase Inhibitors

dc.subject

Logistic Models

dc.subject

Retrospective Studies

dc.subject

Forecasting

dc.subject

Aged

dc.subject

Aged, 80 and over

dc.subject

Medicare

dc.subject

Insurance Claim Review

dc.subject

United States

dc.subject

Female

dc.subject

Male

dc.subject

Medication Adherence

dc.title

Novel application of approaches to predicting medication adherence using medical claims data.

dc.type

Journal article

duke.contributor.orcid

Zullig, Leah L|0000-0002-6638-409X

duke.contributor.orcid

Bosworth, Hayden B|0000-0001-6188-9825

pubs.begin-page

1255

pubs.end-page

1262

pubs.issue

6

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

pubs.organisational-group

Staff

pubs.organisational-group

Basic Science Departments

pubs.organisational-group

Clinical Science Departments

pubs.organisational-group

Institutes and Centers

pubs.organisational-group

Biostatistics & Bioinformatics

pubs.organisational-group

Medicine

pubs.organisational-group

Psychiatry & Behavioral Sciences

pubs.organisational-group

Medicine, General Internal Medicine

pubs.organisational-group

Duke Cancer Institute

pubs.organisational-group

Duke Clinical Research Institute

pubs.organisational-group

Institutes and Provost's Academic Units

pubs.organisational-group

Center for the Study of Aging and Human Development

pubs.organisational-group

Initiatives

pubs.organisational-group

Duke Science & Society

pubs.organisational-group

Population Health Sciences

pubs.organisational-group

Duke Innovation & Entrepreneurship

pubs.organisational-group

Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences

pubs.organisational-group

Duke - Margolis Center For Health Policy

pubs.organisational-group

Biostatistics & Bioinformatics, Division of Biostatistics

pubs.publication-status

Published

pubs.volume

54

Files

Original bundle

Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
Deposit_doi_10.1111_1475-6773.13200.pdf
Size:
663.61 KB
Format:
Adobe Portable Document Format
Description:
Published version