Factors associated with adherence to drug therapy: a population-based study

Bardel, Annika; Wallander, Mari‐Ann; Svärdsudd, Kurt

doi:10.1007/s00228-006-0246-4

Cited by 49 publications

(28 citation statements)

References 29 publications

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“…Younger beneficiaries possibly see adherence to their medication as less of a priority than older individuals. [24][25][26] In the Medicare population, we see a similar pattern, but that pattern is not significant across all medications and years and is not as pronounced as in the commercial population, especially when looking at groups above the age of 65. Medicare beneficiaries below the age of 65 are often disabled and thus are not comparable to the broader Medicare population.…”

Section: ■■ Discussionmentioning

confidence: 68%

Geographic Variation in Medication Adherence in Commercial and Medicare Part D Populations

Couto

Panchal²,

Lal³

et al. 2014

JMCP

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BACKGROUND: Previous literature has emphasized the importance of cost sharing, health literacy, socioeconomic status, cognitive function, disease burden, and polypharmacy as some of the determinants of medication adherence. Little research has been published examining disparities in adherence rates when comparing different regions of the United States.OBJECTIVE: To examine the impact of geography, socioeconomic status, and other demographic variables on medication adherence rates in a large national sample of Medicare Part D and commercially insured beneficiaries.METHODS: This study focused on users of oral antidiabetic, antihypertensive, and/or antilipidemic medications. Beneficiaries who had at least 2 antidiabetic, antihypertensive, or antilipidemic prescription fills in 2010, 2011, or 2012 and who were enrolled in a large commercial or Medicare Part D prescription drug plan for at least 80% of one of these years (9.6 months) were included in this study. Results were stratified by year and by benefit type. Logistic regression was used to test for the adherence differences among the 9 U.S. regions as defined by the U.S. Census Bureau. Additional variables included in the model to control for population differences were age, gender, socioeconomic status, and yearly out-of-pocket medication expenses.RESULTS: After meeting all inclusion and exclusion criteria, 379,533 beneficiaries were in the 2012 Medicare cohort, and 659,553 beneficiaries were in the 2012 commercial cohort. New England was statistically the most adherent geographic region in both cohorts (Medicare odds ratio [OR] = 1.512, CI = 1.399-1.635); commercial OR = 1.193, CI = 1.109-1.284). Younger age beneficiaries, lower income beneficiaries, and females were less adherent in both groups.CONCLUSIONS: In the commercial and Medicare populations, geography, socioeconomic status, age, and gender all impact the likelihood of a beneficiary being adherent to chronic medications for hypertension, diabetes, and hyperlipidemia. While this study does not elucidate the specific factors (i.e., health literacy, disease severity) driving geographic and other differences in medication adherence observed between groups, it does highlight the limitations of quality metrics and wellness initiatives that assume relative homogeneity in beneficiary characteristics across the United States.

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Section: ■■ Discussionmentioning

confidence: 68%

Geographic Variation in Medication Adherence in Commercial and Medicare Part D Populations

Couto

Panchal²,

Lal³

et al. 2014

JMCP

View full text Add to dashboard Cite

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“…Furthermore, the participants were all pre-or early perimenopausal at study entry, allowing us to examine the effects of menopause on drug use in a more precise manner than prior studies. 2,3 Another important strength of this analysis is its longitudinal nature. To our knowledge, all other publications on medication use trends have used cross-sectional methods and compared different study samples over time.…”

Section: Discussionmentioning

confidence: 99%

“…Pain was assessed with the bodily pain scale from the MOS 36-Item Short-Form Health Survey (SF-36), with lower scores representing more pain. Physical activity was measured using a modified version of the Baecke Physical Activity Questionnaire (range [3][4][5][6][7][8][9][10][11][12][13][14][15]. Comorbid conditions were self-reported and included osteoporosis, thyroid disease, any cancer, diabetes mellitus, cardiovascular disease, osteoarthritis, hypertension, migraine, and hyperlipidemia.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…One European study suggested that menopause may drive more medication use, but this has never been assessed directly. 3 None of these surveys questioned the same individuals longitudinally. Little attention has been directed toward comparing medication use among people from different race/ethnicity groups; and the possible influence of the menopause transition on medication use has not been examined.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Medication Use by Race and Ethnicity in Women Transitioning Through the Menopause: A Study of Women's Health Across the Nation Drug Epidemiology Study

Solomon

Ruppert

Greendale

et al. 2016

Journal of Women's Health

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Background: Medication utilization and costs increased over the last decade, but the effects of race/ethnicity have never been well studied in longitudinal data. We analyzed reports of prescription medication use to (1) identify trajectories of use and (2) determine predictors associated with a large increase in use. Specifically, variations in medication use by race/ethnicity were examined. Methods: We analyzed the Study of Women's Health Across the Nation cohort with a median of 14 years of follow-up. Group-based trajectory models helped distinguish women with a low use of medications versus those with heavy use. Logistic regression was used to estimate the odds ratio (OR) for each racial/ethnic group associated with heavy use, controlling for potential baseline confounders. Results: The 2,798 women sampled had a mean age of 46 years at baseline and the median number of medications at baseline was 2, increasing to 4 over the follow-up period. Trajectory models identified that 16% of participants demonstrated heavy use of medications, from a median of 5 at baseline to 10 medications at final follow-up. Regression models controlling for age, obesity, number of comorbid conditions, and pain found that

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“…Ezek egy része az adott betegséggel, mások a beteg személyi-ségével, megint mások a kezelést végzők attitűdjével, tevékenységével függenek össze (1. táblázat) [10].…”

Section: A Terápiahűségunclassified

Alvadásgátló kezelésben részesülő betegek gyógyszer-adherenciája

et al. 2015

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A thromboemboliás kórképek által okozott morbiditás és mortalitás a rendelkezésre álló kezelési lehetőségek ellené-re még mindig igen nagy. Csökkentésének egyik hatékony eszköze lehet a terápiás adherencia (terápiahűség) fokozá-sa, ami a szükséges gyógykezelés minél pontosabb betartását jelenti. Ennek eléréséhez ismernünk kell azokat a ténye-zőket, amelyek a rossz terápiás adherenciát okozzák. Ezek közé tartozik a beteg félelme a gyógyszer mellékhatásaitól, tájékozatlansága betegségével és a szükséges medikációval kapcsolatosan, feledékenysége, illetve számos egyéb társa-dalmi-gazdasági tényező. További ok lehet, ha a beteg úgy érzi, hogy a számára igen lényeges kérdésben a döntést nem vele együtt, hanem mintegy a "feje fölött" hozzák meg. Az alvadásgátló kezelés sokszor élethosszig tart, ezért is nagyon fontos a terápiahűség hosszú távú fenntartása. A kérdés aktualitását az új típusú alvadásgátlók megjelenése adja, amelyek alkalmazása nem igényel rendszeres laboratóriumi ellenőrzést, így kevesebb lehetőségünk van meggyő-ződnünk a terápiahűségről. Az alvadásgátló kezeléssel összefüggő gyógyszer-adherenciával kapcsolatosan számos vizsgálat történt. A terápiahűség fokozása az egyéni kockázati tényezők felmérését követően, elsősorban a rendszeresen ismétlődő betegtájékoztatáson alapul, csoportmunkát igényel, amelyben az orvosnak, gyógyszerésznek, dietetikusnak és ápolónak mind fontos szerep jut. Nagyon fontos az alapellátás szereplőinek gondos és alapos munkája, amit hasznosan egészíthet ki az alvadásgátló klinikák tevékenysége. Orv. Hetil., 2015, 156(32), 1281-1287.Kulcsszavak: thromboembolia, thrombosis, antikoaguláns, új típusú alvadásgátlók, stroke-megelőzés, gyógyszer-adherencia, terápiahűség Drug compliance of patients on anticoagulant treatmentDespite several therapeutic possibilities the morbidity and mortality of thromboembolic disorders remain high. Improving drug compliance -i. e. keeping up the doctor's prescriptions -may be an effective tool to reach better results. To improve patients' compliance, the risk factors of non-compliance should be recognized. Among these patients' fear of adverse effects of drugs, their lack of knowledge about their illness and medication, forgetfulness, and other social, economic factors may be the most important. Furthermore, adherence may be worsened when the patient feels that the decision has been made over his/her head. Sustained medical adherence is important because anticoagulation may be a life-long treatment. The new oral anticoagulants make the matter of compliance to be current. These new type of drugs do not need regular laboratory monitoring and, therefore, compliance cannot be strictly followed. There are several studies concerning drug compliance to anticoagulant medications. Improvement of adherence is based on regular patient education after reviewing the factors of non-compliance, which needs teamwork with important roles of doctors, pharmacists, dietetics and nurses. Careful and accurate work of the participants of primary care might be complemented by t...

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Factors associated with adherence to drug therapy: a population-based study

Abstract: Factors that were associated with the perceived importance of medication had a positive effect on adherence, while concerns about medication safety had a negative effect.

Cited by 49 publications

References 29 publications

Geographic Variation in Medication Adherence in Commercial and Medicare Part D Populations

Geographic Variation in Medication Adherence in Commercial and Medicare Part D Populations

Medication Use by Race and Ethnicity in Women Transitioning Through the Menopause: A Study of Women's Health Across the Nation Drug Epidemiology Study

Alvadásgátló kezelésben részesülő betegek gyógyszer-adherenciája

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