• Examining Persistence for Ibrance (palbociclib) for FDA Approved indication and dosing through a retrospective analysis

      Mathews, Kelly; Gianninoto, Jenna; Slack, Marion; Alanis, Elizabeth; Leon, Terra; Ochoa, Nicole; Tschida, Melanie; College of Pharmacy, The University of Arizona (The University of Arizona., 2019)
      Specific Aims: To determine whether receiving all medication therapy from a single pharmacy positively impacts medication adherence and lengthens duration of therapy in patients who are taking palbociclib for the treatment of HR+, HER2- metastatic breast cancer. Methods: In a retrospective cohort study, we analyzed 347 patients concurrently taking palbociclib and letrozole or fulvestrant. Patients with HR+, HER2- metastatic breast cancer currently on combination therapy of palbociclib and letrozole or fulvestrant filling at Avella Specialty Pharmacy between March 2016 to December 2017. Patients were divided into two groups characterized by those that filled both agents at Avella Specialty Pharmacy and those that only filled palbociclib at Avella and the other agent at a retail pharmacy. We compared the mean length of therapy, the PDC mean, and payor type between both patient groups. Primary outcome was the Proportion of Days Covered (PDC). Secondary outcomes included days on therapy and payor type. Main Results: Data analysis was conducted among the 347 patients (mean age = 69.37; SD = 11.40). Comparison of PDC mean resulted in no significant difference (SPP mean = 94.5%, SD = 0.11; Non-SPP mean = 95.06%, SD = 0.09; t-test p-value = 0.82/Mann-Whitney U test p-value = 0.76). Days on therapy presented no significant difference (SPP mean = 177.81, SD = 136.95; Non-SPP mean = 173.09, SD 157.69; t-test p-value= 0.83/Mann-Whitney U test p-value: 0.07). Comparison of payor type between patient groups had no significant difference (p-value = 0.13). Conclusions: Adherence and length of therapy for patients filling both agents at Avella were similar to those filling the second agent at an alternative retail pharmacy.
    • Using Short Messaging Service (SMS) Technology to Improve Medication Adherence in Patients with Specialty Chronic Diseases at Avella Specialty Pharmacy

      Mathews, Kelly; Cooley, Janet; Gianninoto, Jenna; Goal, Oliver; Lok, Daniel; Wilkerson, Aaron; College of Pharmacy, The University of Arizona (The University of Arizona., 2018)
      Purpose: The purpose was to evaluate the use of the CareSpeak Text Message Service (SMS) on adherence rate, time on therapy, and patient satisfaction. Methods: This retrospective, chart review evaluated patients using the CareSpeak SMS program at Avella Specialty Pharmacy receiving medications for cancer, hepatitis C, Human Immunodeficiency Virus (HIV), and inflammatory conditions from November 1, 2016 through November, 30 2017. Patients were grouped by disease state as well as Carespeak enrollment status. Information on proportion of days covered (PDC), time on therapy, and patient satisfaction were collected. Main Results: A total of 17,890 patients were evaluated. The median PDC ratio for patients with HIV was 94.63% for the non-Carespeak group and 96.5% for patients using Carespeak (P<0.001). Median Time on Therapy in days was significantly greater in the Carespeak group compared to the non-Carespeak group for patients receiving medications for oncology (340 vs 266.5 days, P<0.001), Hepatitis C (106 vs 101, P<0.001), HIV (396 vs 389, P=0.010), and Inflammatory Conditions (162 vs 160, P<0.001). Of a total of 1,159 satisfaction survey responses collected, Carespeak SMS received A’s or B’s (on a letter grade scale of A to F) in 91% of responses for helpfulness in managing patient health and 94.5% for ease of use. Conclusions: The CareSpeak SMS program was associated with improved PDC ratios in patients with HIV as well as prolonged Time on Therapy across all disease states. The Carespeak SMS service was generally graded highly in terms of helpfulness and ease of use.