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Patient Prefer Adherence. 2018 Oct 5;12:1975-1987. doi: 10.2147/PPA.S164819. eCollection 2018.

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

Author information

1
CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, Naples, Italy, enrica.menditto@unina.it.
2
Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.
3
Aragon Health Sciences Institute (IACS), IIS Aragón, REDISSEC ISCIII, Madrid, Spain.
4
Aragon Health Service (SALUD), Aragon, Spain.
5
Department of Public Health, Federico II University, Naples, Italy.
6
University of Zaragoza, Zaragoza, Spain.
7
UCIBIO, REQUINTE, Faculty of Pharmacy, Porto4ageing Reference Site, University of Porto, Porto, Portugal.
8
Department of Family Medicine, Medical University of Lodz, Lodz, Poland.

Abstract

Purpose:

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 antihy-perlipidemics, 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

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

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