ReviewJournal of managed care & specialty pharmacy2021
Is it time to replace the star ratings adherence measures?
Review in Journal of managed care & specialty pharmacy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed.
- Association of diabetes medication adherence quality measure performance with A1c control among Medicare Advantage beneficiaries.Journal of managed care & specialty pharmacy · 2026Article
- Measuring Adherence to Multiple Medications Using Guideline-Directed Medical Therapy as a Model.medRxiv : the preprint server for health sciences · 2025Article
- Examining the association between medication adherence trajectories and disease-specific clinical outcomes: An analysis focusing on the drug classes included in Part D quality bonus payments.Journal of managed care & specialty pharmacy · 2025Article
- Investigating the Time-Varying Nature of Medication Adherence Predictors: An Experimental Approach Using Andersen's Behavioral Model of Health Services Use.Pharmacy (Basel, Switzerland) · 2025Article
- Estimating optimal thresholds for adherence to RASA medications among older adults with hypertension.Journal of managed care & specialty pharmacy · 2025Article
- Estimation of optimal adherence threshold for tumor necrosis factor inhibitors in rheumatoid arthritis.Clinical rheumatology · 2024Article
- Association of PCSK9 Inhibitor Initiation on Statin Adherence and Discontinuation.Journal of the American Heart Association · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Measures of medication adherence to noninsulin diabetes medications (NIDM), statins, and renin angiotensin system antagonists (RASA) have been continuously used in the star ratings program since 2012. Adherence to these treatments is undoubtedly important. However, the consistent use of these measures in the star ratings program over time has limitations. The purpose of this Viewpoints article is to highlight concerns associated with the current star ratings adherence measures and to offer proposals for the improvement of the adherence measurement in the program. This scoping review outlines concerns with the validity of the 3 star ratings adherence measures. In addition, star ratings data are used to describe payment thresholds for the 3 adherence measures over time to describe concerns associated with their use. Since 2012, there has been significant growth in the proportion of patients considered adherent in the star ratings program. Rates of adherence in a 2-star plan for NIDM (79%), RASA agents (83%), and statins (79%) now exceed what is commonly reported in the clinical literature. For a plan to achieve a rating of 5 stars, more than 88% of patients must be adherent to each measure. These rates suggest a ceiling effect and a reduced ability to distinguish plan performance. In addition, concerns over the potential for plans to "game" these measures have been raised. The use of mail order services, 90-day prescription refill programs, and automatic refill reminders all improve the proportion of days covered measurement but may not reflect true adherence improvements. Given potential concerns associated with the use of the existing adherence measures, it may be time to consider their replacement. One option would be to adopt a broader inventory of chronic medications to measure adherence in the program and to rotate medication categories in the program each year. It might also be time to explore measuring patient adherence to all medications that a patient uses instead of the narrow focus on the 3 existing measures.
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