Improving Medication Adherence and Medication Optimization With a Medicaid-Funded Statewide Diabetes Quality Improvement Project

Medication adherence is a barrier to achieving glycemic goals among Medicaid recipients with diabetes. The Diabetes Quality Improvement Program Collaborative recruited 19 primary care practices serving a high volume of Medicaid patients in Ohio with the goal of reducing the percentage of adults with type 2 diabetes with A1C >9.0% through a 1-year intervention. The mean medication possession ratio (MPR) improved from 71.6% during the pre-intervention period to 74.1% at year 1 post-intervention—a relative improvement of 3.4%. Factors associated with a lower MPR included younger age, identifying as non-Hispanic Black or Hispanic, and a pre-intervention A1C >9.0%. Although the initiative modestly improved medication adherence, addressing persistent disparities and expanding prescribing of therapies with cardiorenal benefits will be necessary to improve diabetes outcomes in the Medicaid population.