Greta Bushnell

Pharmacoepidemiologists - come work with us! @RutgersPETS @RutgersIFH Open Rank Faculty Position, Rutgers Center for Pharmacoepidemiology and Treatment Science: jobs.rutgers.edu/postings/150289

@lauffenburgerjc @adherence_ispe Yes! Claims and self-report would be really interesting to see compared with the blood draw results #adherencejc

@adherence_ispe I would be super curious if one could link to claims, or even do a 7-day self-reported adherence measure at the same time as the blood draw, would probably given more helpful options as to how to interpret the results #adherencejc

@lauffenburgerjc @adherence_ispe @danielankrah45 @lauffenburgerjc Yes, I think so --- and opportunity to inquire about unknown medication use - ex. opioids and benzodiazepines #adherencejc

@GretaBushnell @adherence_ispe @danielankrah45 Perhaps could be used to at least update the drug list after a visit? #adherencejc

@adherence_ispe Yes I agree @lauffenburgerjc and I found the potential drug interactions findings interesting -- particularly when involving medications not in the EHR

@lauffenburgerjc @adherence_ispe I'm also here! #adherencejc

@adherence_ispe I'm here! #adherencejc

@adherence_ispe (I have to head out early, great #adherencejc everyone! Thanks @adherence_ispe )

@lauffenburgerjc I also wonder at what point those with TRH who are adherent begin alternative interventions and discontinue medications #adherencejc

I thought that was potentially a result of multiple measurement or again the way adherence was measured? The other covariate associations with poor adherence (e.g., having diabetes or being born outside of Europe) track better with other studies. Interesting though. #adherencejc twitter.com/adherence_ispe…

@lauffenburgerjc @adherence_ispe Yes I agree, that was a great addition

@adherence_ispe Outside of that, I did find it interesting that they could measure some covariates like birth outside of Europe, education or income. Usually we do not have that information in these claims databases and have to approximate that info. #adherencejc

@lauffenburgerjc @adherence_ispe Yes I agree. Within prevalent users I do like the idea of starting at a blood pressure measurement given this may represent a point when adherence interventions could be implemented #adherencejc

@adherence_ispe Good point - though it's likely that almost everyone was a prevalent user (though we don't know for sure)

@adherence_ispe @SarahJoSinnott They did allow switching within and between drug classes... I’m sure calculating the pdc gets complicated quickly with multiple drugs within a class! #adherencejc

@adherence_ispe twitter.com/SarahJoSinnott…

@adherence_ispe @lauffenburgerjc @DurandHannah I wasn’t entirely clear why it was restricted to patients with high adherence during baseline #adherencejc

@lauffenburgerjc @adherence_ispe Yes I agree! And very useful that they were able to use blood pressure measurements

@adherence_ispe I thought it was interesting. I appreciate seeing studies done in longitudinal databases where insurance churn is less of a problem. Clearly treatment resistant HTN remains a big problem and we need to do more to isolate what is attributable to poor adherence

@adherence_ispe The multiple aspects included in the intervention along with providing useful subgroup results, which could help improve this intervention when used in other populations #adherencejc

@lauffenburgerjc @adherence_ispe Yes table 2! The provided subgroup results were interesting

@GretaBushnell @adherence_ispe That's a good point! I didn't really catch that initially (Table 2 is what you're referring to)? They did have an improvement in all-cause readmits+observations. Even though not significant, the HR is pretty large

@adherence_ispe One challenge may be the individuals willing/wanting to participate were more likely to be adherent and partake in other healthy behaviors #adherencejc

@adherence_ispe I agree Julie! And while not statistically significant, there does seem to be a lot of potential with the intervention given cost reductions and 4% increase in mean PDC #adherencejc

@adherence_ispe Here as well!