Volume 28, Issue 4 p. 437-443
Free Access

Comparison of Drug Adherence Rates Among Patients with Seven Different Medical Conditions

Dr. Becky A. Briesacher Ph.D.

Corresponding Author

Dr. Becky A. Briesacher Ph.D.

Division of Geriatric Medicine, University of Massachusetts Medical School, Worcester, Massachusetts

Meyers Primary Care Institute, Worcester, Massachusetts

Division of Geriatric Medicine, University of Massachusetts Medical School, Biotech Four, Suite 315, 377 Plantation Street, Worcester, MA 01605; e-mail: [email protected].Search for more papers by this author
Dr. Susan E. Andrade Sc.D.

Dr. Susan E. Andrade Sc.D.

Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts

Meyers Primary Care Institute, Worcester, Massachusetts

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Mr. Hassan Fouayzi M.S.

Mr. Hassan Fouayzi M.S.

Meyers Primary Care Institute, Worcester, Massachusetts

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Dr. K. Arnold Chan M.D.

Dr. K. Arnold Chan M.D.

Harvard School of Public Health, Boston, Massachusetts

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First published: 06 January 2012
Citations: 420

Abstract

Study Objective. To compare drug adherence rates among patients with gout, hypercholesterolemia, hypertension, hypothyroidism, osteoporosis, seizure disorders, and type 2 diabetes mellitus by using a standardized approach.

Design. Longitudinal study

Data Source. Health care claims data from 2001–2004.

Patients. A total of 706,032 adults aged 18 years or older with at least one of the seven medical conditions and with incident use of drug therapy for that condition.

Measurements and Main Results. Drug adherence was measured as the sum of the days' supply of drug therapy over the first year observed. Covariates were age, sex, geographic residence, type of health plan, and a comorbidity score calculated by using the Hierarchical Condition Categories risk adjuster. Bivariate statistics and stratification analyses were used to assess unadjusted means and frequency distributions. Sample sizes ranged from 4984 subjects for seizure disorders to 457,395 for hypertension. During the first year of drug therapy, 72.3% of individuals with hypertension achieved adherence rates of 80% or better compared with 68.4%, 65.4%, 60.8%, 54.6%, 51.2%, or 36.8% for those with hypothyroidism, type 2 diabetes, seizure disorders, hypercholesterolemia, osteoporosis, or gout, respectively. Age younger than 60 years was associated with lower adherence across all diseases except seizure disorders. Comorbidity burden and adherence varied by disease. As comorbidity increased, adherence among subjects with osteoporosis decreased, whereas adherence among those with hypertension, hypercholesterolemia, or gout increased. Add-on drug therapies and previous experience with taking drugs for the condition increased adherence among subjects with hypertension, type 2 diabetes, hypothyroidism, or seizure disorders but not the other conditions.

Conclusion. This uniform comparison of drug adherence revealed modest variation across six of seven diseases, with the outlier condition being gout.