Development of a graphical tool to measure medication adherence in asthma patients: A mixed-methods pilot study

Objectives: (1) To develop Med-Resp, a graphical tool based on prescription refills to measure adherence and use of asthma medications; (2) To test the feasibility of implementing Med-Resp in a hospital outpatient asthma clinic; (3) To explore the effectiveness of Med-Resp to improve medication adherence to asthma controller medications. Methods: A sequential exploratory design was used: (1) Prototype design in collaboration with respiratory physicians and patients via focus groups; (2) Med-Resp creation based on algorithms developed and applied to prescription refills data recorded in the drug claims database reMed; (3) Feasibility assessment of the implementation of Med-Resp in the outpatient asthma clinic; and (4) Exploration of the effectiveness of Med-Resp through a pre-post design. Results: A total of 29 patients and six respiratory physicians participated in this pilot study. The tool was highly appreciated by the participants, while the majority believed that Med-Resp has the potential to enhance physician-patient communication and aid in treatment decisions. The feasibility of implementing Med-Resp in clinical practice was demonstrated. However, we did not observe an increase in medication adherence in the six months following its implementation. Conclusion: In the clinical setting, the use of prescription refills data may constitute a non-invasive and objective measure of medication adherence. This study highlights the importance of providing clinicians with objective and easily interpretable measures of medication adherence and use in routine clinical practice. Med-Resp has the potential to become implemented on a larger scale if integrated in electronic medical records.