Medication Compliance and Persistence: Terminology and Definitions

Cramer, Joyce A.; Roy, Anuja; Burrell, Anita; Fairchild, Carol; Fuldeore, Mahesh; Ollendorf, Daniel A.; Wong, Peter

doi:10.1111/j.1524-4733.2007.00213.x

Cited by 1,807 publications

(1,522 citation statements)

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“…Our epidemiological data were either obtained from statistics provided by national institutions or extrapolated estimates from scientific literature. Our estimates for adherence rates were taken from a number of different studies which could have used definitions different to that given in our study [16]. Likewise, costs were obtained from a number of data sources using methods and definitions which may have varied from one country to the other.…”

Section: Discussionmentioning

confidence: 99%

“…Hypertensive patients (BP C 140/90) may or may not be diagnosed with hypertension. The model assumes that all diagnosed patients are treated and that adherence to treatment (defined as the extent to which a patient acts in accordance with the prescribed interval and dose of a dosing regimen [16]) is the main driver for the patient to achieve a controlled blood pressure (BP \ 140/90) and consequently a lower probability of experiencing a cardiovascular event.…”

Section: Modelmentioning

confidence: 99%

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Cost of poor adherence to anti-hypertensive therapy in five European countries

et al. 2014

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The financial burden for EU health systems associated with cardiovascular disease (CV) has been estimated to be nearly €110 billion in 2006, corresponding to 10 % of total healthcare expenditure across EU or a mean €223 annual cost per capita. The main purpose of this study is to estimate the costs related to hypertension and the economic impact of increasing adherence to anti-hypertensive therapy in five European countries (Italy, Germany, France, Spain and England). A probabilistic prevalence-based decision tree model was developed to estimate the direct costs of CV related to hypertension (CV defined as: stroke, heart attack, heart failure) in five European countries. Our model considered adherence to hypertension treatment as a main driver of blood pressure (BP) control (BP \ 140/ 90 mmHg). Relative risk of CV, based on controlled or uncontrolled BP group, was estimated from the Framingham Heart Study and national review data. Prevalence and cost data were estimated from national literature reviews. A national payer (NP) perspective for 10 years was considered. Probabilistic sensitivity analysis was performed in order to evaluate uncertainty around the results (given as 95 % confidence intervals). The model estimated a total of 8.6 million (1.4 in Italy, 3.3 in Germany, 1.2 in Spain, 1.8 in France and 0.9 in England) CV events related to hypertension over the 10-year time horizon. Increasing the adherence rate to antihypertensive therapy to 70 % (baseline value is different for each country) would lead to 82,235 fewer CV events (24,058 in Italy,7,870 in Germany,18,870 in Spain,24,855 in France and 6,553 in England). From the NP perspective, the direct cost associated with hypertension was estimated to be €51.3Electronic supplementary material The online version of this article (doi:10.1007/s10198-013-0554-4) contains supplementary material, which is available to authorized users. 123Eur J Health Econ (2015) 16:65-72 DOI 10.1007 billion (8.1 in Italy, 17.1 in Germany, 12.2 in Spain, 8.8 in France and 5.0 in England). Increasing adherence to antihypertensive therapy to 70 % would save a total of €332 million (CI 95 %: €319-346 million) from the NPs perspective. This study is the first attempt to estimate the economic impact of non-adherence amongst patients with diagnosed hypertension in Europe, using data from five European countries (Italy, France, Germany, Spain and England).

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Section: Discussionmentioning

confidence: 99%

Section: Modelmentioning

confidence: 99%

Cost of poor adherence to anti-hypertensive therapy in five European countries

et al. 2014

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“…It can be defined as the extent to which a patient acts in accordance with the prescribed interval and dose of a dosing regimen. Compliance is usually measured over a period of time and reported as a percentage [29]. Compliance differs from persistence, which is defined as the duration of time from initiation to discontinuation of therapy.…”

Section: The Importance Of Compliance Persistence and Adherence For mentioning

confidence: 99%

Differences in persistence, safety and efficacy of generic and original branded once weekly bisphosphonates in patients with postmenopausal osteoporosis: 1-year results of a retrospective patient chart review analysis

Ringe

Möller

2009

Rheumatol Int

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“…Three systematic reviews have been conducted on oral antineoplastic agents. One review of 12 studies used the most commonly cited definition of adherence in the literature, 'the extent to which a person's behavior coincides with medical or health advice', 14 a second review (n = 22) used the ISPOR definition, 15 while the third (n = 6) concluded that no standard definition of adherence was used across studies and this made comparison of results between studies difficult. 16 Of the 43 studies in the literature, only 24 reported a definition of adherence (See article on assessment and measurement elsewhere in this issue).…”

Section: Operational Definition Of the Health Status Outcome Adherencementioning

confidence: 99%