About This Tool
Overview
How It Works
Interpreting Results
Evidence
Limitations
MEDICATION ADHERENCE CALCULATOR
This tool analyzes prescription fill data to calculate medication adherence rates. It is designed to work with CSV exports from Kroll pharmacy software (RxSummary report).
KEY FEATURES:
• Automated PDC calculations based on fill dates and inferred day supply
• Summary view showing average adherence by medication
• Detailed view showing individual prescription fills
• Editable day supply values for manual corrections
• PDF and CSV export
WHAT YOU NEED:
• CSV file from Kroll (RxSummary report)
• Basic understanding of adherence metrics
This tool provides a structured, reproducible way to estimate adherence, supporting pharmacist-led interventions and documentation.
HOW ADHERENCE IS CALCULATED
1. DATA PROCESSING:
• Loads prescription fill data from CSV
• Groups prescriptions by medication and strength
• Sorts fills by date to establish chronological order
2. DAY SUPPLY CALCULATION:
• Extracts day supply from prescription directions using Sig pattern matching
• Example: "Take 1 tablet daily" + quantity 30 → 30-day supply
• Allows manual editing of day supply values
3. ADHERENCE CALCULATION:
• Adherence % = (Day Supply ÷ Actual Days Between Fills) × 100
4. SUMMARY STATISTICS:
• Averages adherence across all fills for each medication
EXAMPLE:
• Fill 1: January 1st, 30-day supply
• Fill 2: February 5th (35 days later)
• Adherence = (30 ÷ 35) × 100 = 85.7%
INTERPRETING RESULTS
ADHERENCE THRESHOLDS:
• Above 90% — Good (green)
• 80–90% — At Risk (amber)
• Below 80% — Poor (red)
These thresholds are based on research linking adherence below 80% to adverse clinical outcomes.
SUMMARY VIEW:
• Shows average adherence per medication
• More fills = more reliable average
• Medications with few fills may show skewed results
DETAILED VIEW:
• Individual fills and their adherence rates
• Actual days between fills vs. expected day supply
RED FLAGS:
• Consistently low adherence across multiple medications
• Large gaps between expected and actual refill dates
• Adherence >100% may indicate early fills or inaccurate day supply
WHY ADHERENCE MATTERS
Adherence below 80% is linked to increased hospitalizations, disease progression, and mortality in chronic conditions including hypertension, diabetes, heart failure, and mental illness.
EFFECTIVE INTERVENTIONS:
• Compliance Packaging: 5–15% improvement over usual care
• SMS Reminders: 10–20% improvement, better disease control
• Automatic Refills: Modest but reliable gains
• Pharmacist-led MTM: 15–25% improvement, reduced hospital admissions
Monitoring adherence allows pharmacists to identify at-risk patients, implement targeted interventions, and document outcomes-based care.
LIMITATIONS
• Results depend on accurate prescription data in source system
• Day supply calculations may not reflect actual patient usage
• Does not account for medication sharing, splitting, or disposal
• Assumes patients take medication consistently during each fill period
• PRN medications are not suitable for adherence calculations
• Missing or incomplete data affects calculation accuracy
PRIVACY:
• Users are responsible for PHIPA/PIPEDA compliance
• No patient data is stored or transmitted by this tool
• Secure handling and timely disposal of CSV files is essential
Always verify results against patient charts. Use as a screening tool, not a definitive assessment.
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