Changing the Default Prescription Length to Increase Statin Medication Adherence
Issue
Statins are cost-effective medications that reduce the risk of cardiovascular disease, yet many patients are not adherent.
The Idea
Having medication readily available helps with adherence; longer prescription durations allow patients to stay adherent more easily by reducing the number of times they need to obtain the medication. So, what would happen if the number of statin pills clinicians gave patients changed from a 30-day supply to a 90-day supply?
Results
A team of researchers at the University of Pennsylvania switched the default for statin prescribing in the electronic health record to a 90-day supply with 3 refills unless the provider opted out.
The proportion of prescriptions written for a 90-day supply increased from 71% to 92% following the intervention, an adjusted increase of around 20 percentage points.
A bonus: Racial and socioeconomic disparities in prescription length were reduced as well.
“Although the study did not assess adherence as a result of the increase in 90-day prescription rates, other studies have demonstrated that 90-day prescription fills are associated with greater adherence and reduced mortality,” the authors wrote.
Find the JAMA Internal Medicine paper here, and see how the work was described in the editor’s note “Making the right choice easy.”
Impact
The 90-day default has been scaled across Penn Medicine, and the 90-day default has since been applied to not only statins but also hypertension and diabetes drugs as well.