Medication Therapy Management Improves Adherence in IBD

Compared with standard-of-care for patients with inflammatory bowel disease (IBD), a new study found that

medication therapy management

(MTM) increased adherence more than 30%.

A first of its kind

study

, conducted by Curant Health and Johns Hopkins Medicine’s Meyerhoff Inflammatory Bowel Disease Center, sought to determine the efficacy of an IBD MTM patient fulfillment model in comparison with standard care in a large university hospital outpatient setting.

For the study, researchers enrolled individuals diagnosed with ulcerative colitis (UC) or Crohn’s disease (CD) who were receiving IBD therapy. Patients who were on infliximab monotherapy were excluded from the study. All participants were age 18 and older.

Participants were randomized into 1 of 3 groups: the intervention arm (n=100) where patients received standard of care treatment, fulfillment of medications, and enhanced MTM through innovative medication management organization (MMO); the control arm 1 (n=50) with standard-of-care treatment and fulfillment of medications by an innovative MMO; and control arm 2 (n=50) with standard of care treatment only.

Enrollment will continue until 200 participants are enrolled, and the study will evaluate 24 months of treatment with an opt-in for an additional 2 years.

To measure IBD therapy adherence rates, researchers used a self-reported adherence measure validated for use in IBD called Morisky Medication Adherence Scale (MMAS-8). Furthermore, prescription claims in the intervention arm and control arm 1 will be used to calculate medication possession ratios (MPR).

Adherence is defined as MPR that exceeds 80%. To date, 110 individuals have been randomized, 24 of whom were excluded primarily because of insurance restrictions.

The preliminary results of Project A.L.I.V.E. (Adherence and Long-term IBD Value-added Effectiveness) revealed that of these patients, 55% in the intervention arm who received MTM were considered to have improved adherence, compared with 25% in both of the control arms.

Among participants who had at least 3 prescription fills, 100% (n=10) in the intervention arm and 90% (n=9) in control arm 1 were considered adherent to treatment based on the MPR.

“Project A.L.I.V.E. is well on its way to measuring program value for IBD patients and caregivers with preliminary results showing improved adherence in the treatment arm,” researcher Vickie Andros, PharmD, director of Clinical Pharmacy at Curant Health, said in a press release. “We anticipate that our enhanced medication therapy management and patient support services will continue to demonstrate project value through outcomes improvement and impact on cost through a reduction in hospitalizations and ED visits for this patient population. Continuing to validate our work alongside Dr Dudley-Brown, her colleagues, and most importantly improving the lives of people suffering from IBD, is central to our mission.”

Once the study is completed, it will contain the first reported long-term adherence data for UC or CD, and the first published data evaluating the impact of MTM on IBD outcomes, according to Curant Health.