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The newly developed Prescription Medication Non-Adherence Prediction Tool, or Rx-NAPT, may help clinicians identify patients with fibromyalgia who are more likely not to comply with the prescribed treatment.
This tool can improve communication between patients and healthcare providers, reducing the social, clinical, and economic burden of correcting noncompliance in patients with fibromyalgia.
Rx-NAPT was described in the retrospective study “Risk of medication non‐adherence among Medicaid enrollees with fibromyalgia: Development of a validated risk prediction tool” that appeared in the journal Pain Practice.
Fibromyalgia is associated with a high economic burden to patients, but also to society. Studies have shown that direct healthcare costs are three times higher for fibromyalgia patients than for those without the disease. Indirect costs such as pain and loss of productivity are more than two times higher in these patients.
According to data from 2007, about 34 percent of fibromyalgia patients in the United States spend between $100 and $1,000 per month beyond their insurance to see a healthcare professional. This is an important contributing factor in high noncompliance rates among these patients.
“Unfortunately, payers frequently pass the subsequent financial pressures over to patients through higher copayment mechanisms, a process which plays a further role in non-adherence,” researchers stated.
To improve patient outcomes and reduce the burden associated with this disease, it is essential to find ways to help predict and prevent treatment non-adherence.
Researchers at the University of Florida used data collected from 6,626 patients with fibromyalgia who were enrolled in Medicaid to develop a tool that could help predict non-adherence risk.
Most of the patients (86.43%) were women and more than half were between 40 and 64 years old. According to Medicaid records, 94.22% of the patients received the prescribed medication for more than 30 days, and 55.09% were taking Cymbalta (duloxetine).
The tool was built based on several parameters of patients’ personal information, which have been shown to help predict treatment adherence. These included gender, age, race, presence of fibromyalgia complications, health maintenance organization (HMO) insurance coverage, emergency room utilization, and medication used.
The mean Rx-NAPT score can range between 54 and 91, with 70 being the value at which patients are considered at high risk for noncompliance.
About 72.5% of the patients were estimated to be noncompliant with the prescribed treatment, according to medication possession ratio (MPR) scores.
Using the Rx-NAPT tool, the team confirmed that 33.3% of adherent patients were at high risk for non-adherence. The tool showed its ability to predict non-adherence with an accuracy of approximately 62-64%.
“To our knowledge, this is the first study estimating non-adherence risk assessment in fibromyalgia patients,” they said. “We believe this tool can play an important role in addressing the needs and shortcomings of existing medication adherence programs and contribute to resolve the existing burden of non-adherence among this population, including poor clinical outcomes and increased costs of care.”