Patient Adherence and Outcomes Flashcards

A patient's fill history over a 180-day measurement period shows 150 unique days covered by medication. What is the proportion of days covered (PDC)?

Answer: 0.83

PDC equals days covered divided by days in the period, so 150/180 = 0.83.

Why can the medication possession ratio (MPR) exceed 1.0 while PDC cannot?

Answer: MPR sums days' supply without adjusting for overlapping fills

MPR adds total days' supply dispensed, so early or overlapping refills can push it above 100%, whereas PDC counts each day only once.

What PDC threshold is most commonly used by PQA and CMS Star Ratings to define a patient as adherent?

Answer: 80%

The Pharmacy Quality Alliance standard defines adherence as PDC of at least 80% for most chronic medication classes.

A patient never picks up a newly prescribed biologic after the prescription is processed. This is best described as:

Answer: Primary nonadherence

Primary nonadherence occurs when a new prescription is never filled or never picked up.

A patient stops taking an oral anticancer agent because she believes the nausea outweighs the benefit. This is classified as:

Answer: Intentional nonadherence

A deliberate decision to stop or alter therapy based on beliefs or side effects is intentional nonadherence.

Which method is the most reliable way to confirm a patient understood injection instructions given during counseling?

Answer: Ask the patient to explain and demonstrate the steps back (teach-back)

Teach-back with return demonstration directly verifies comprehension and technique rather than assuming understanding.

In specialty pharmacy, 'persistence' refers to:

Answer: The duration from therapy initiation to discontinuation

Persistence measures how long a patient continues therapy, typically ending when a permissible gap (e.g., 30–60 days) is exceeded.