Patient Preference and Adherence (Oct 2018)

Adherence to chronic medication in older populations: application of a common protocol among three European cohorts

  • Menditto E,
  • Cahir C,
  • Aza-Pascual-Salcedo M,
  • Bruzzese D,
  • Poblador-Plou B,
  • Malo S,
  • Costa E,
  • González-Rubio F,
  • Gimeno-Miguel A,
  • Orlando V,
  • Kardas P,
  • Prados-Torres A

Journal volume & issue
Vol. Volume 12
pp. 1975 – 1987

Abstract

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Enrica Menditto,1,* Caitriona Cahir,2,* Mercedes Aza-Pascual-Salcedo,3,4 Dario Bruzzese,5 Beatriz Poblador-Plou,3 Sara Malo,6 Elisio Costa,7 Francisca González-Rubio,3,4,6 Antonio Gimeno-Miguel,3 Valentina Orlando,1 Przemyslaw Kardas,8 Alexandra Prados-Torres3 1CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, Naples, Italy; 2Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland; 3Aragon Health Sciences Institute (IACS), IIS Aragón, REDISSEC ISCIII, Madrid, Spain; 4Aragon Health Service (SALUD), Aragon, Spain; 5Department of Public Health, Federico II University, Naples, Italy; 6University of Zaragoza, Zaragoza, Spain; 7UCIBIO, REQUINTE, Faculty of Pharmacy, Porto4ageing Reference Site, University of Porto, Porto, Portugal; 8Department of Family Medicine, Medical University of Lodz, Lodz, Poland *These authors contributed equally to this workPurpose: The purpose of this study was to evaluate and compare medication adherence to chronic therapies in older populations across different regions in Europe.Methods: This explorative study applied a harmonized method of data extraction and analysis from pharmacy claims databases of three European countries to compare medication adherence at a cross-country level. Data were obtained for the period between January 1, 2010, and December 31, 2011. Patients (aged ≥65 years) who newly initiated to oral antidiabetics, antihyperlipidemics, or antiosteoporotics were identified and followed for over a 12-month period. Main outcome measures were medication adherence (medication possession ratio, [MPR]; implementation) and persistence on index treatment. All country-specific data sets were prepared by employing a common data input model. Outcome measures were calculated for each country and pooled using random effect models.Results: In total, 39,186 new users were analyzed. In pooled data from the three countries, suboptimal implementation (MPR <80%) was 52.45% (95% CI: 33.43–70.79) for antihyperlipidemics, 61.35% (95% CI: 52.83–69.22) for antiosteoporotics, and 30.33% (95% CI: 25.53–35.60) for oral antidiabetics. Similarly, rates of non-persistence (discontinuation) were 55.63% (95% CI: 35.24–74.29) for antihyperlipidemics, 60.24% (95% CI: 45.35–73.46) for antiosteoporotics, and 46.80% (95% CI: 36.40–57.4) for oral antidiabetics.Conclusion: Medication adherence was suboptimal with >50% of older people non-adherent to antihyperlipidemics and antiosteoporotics in the three European cohorts. However, the degree of variability in adherence rates among the three countries was high. A harmonized method of data extraction and analysis across health-related database in Europe is useful to compare medication-taking behavior at a cross-country level. Keywords: drug utilization, medication adherence, medication persistence, prescribing

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