Heart Month: Adherence to Heart Failure Medications Varies by Region

By: Allison Hydzik

On average, only about half of a random sample of Medicare Part D recipients were adhering to their life-saving heart failure medications – with rates as low as 36 percent in some parts of the U.S.

The findings were made by University of Pittsburgh Graduate School of Public Health associate professor Yuting Zhang, Ph.D., and are reported in the Feb. 11 issue of JAMA Internal Medicine.

“What was particularly interesting about our results is that we found that areas with higher drug spending did not have systemically better adherence,” said Dr. Zhang, a health economist. “This suggests that areas with higher drug spending are not necessarily doing a better job caring for patients with heart failure.”
Using national Medicare Part D data from 2007 through 2009, Dr. Zhang and her colleagues pulled a random sample of  5 percent of the beneficiaries with heart failure. They found that, on average, 52 percent of the patients were filling their prescriptions for heart failure medication.
The region with the lowest adherence, at 36 percent, was the Slidell, La., area. The St. Cloud, Minn., area had the highest adherence, at 71 percent. The Pittsburgh area had an adherence rate of 49 percent.

“The areas with better adherence could provide a useful benchmark for what is achievable, and system-level quality metrics that incorporate adherence, rather than focusing solely on drug spending, could promote more efficient use of resources,” Dr. Zhang said.

Co-authors of the research letter include Shang-Hua Wu, M.S., Pitt Public Health; A. Mark Fendrick, M.D., University of Michigan School of Public Health; and Katherine Baicker, Ph.D., Harvard School of Public Health.