A Snapshot of Medication Adherence Across Three European Countries: Application of Common Methodology

• Published in: Value in health Vol. 20; no. 9; p. A742
• Main Authors: Menditto, E, Cahir, C, Aza, M, Poblador Plou, B, Malo, S, Bruzzese, D, González Rubio, F, Kardas, P, Prados-Torres, A
• Format: Journal Article
• Language: English
• Published: Lawrenceville Elsevier Science Ltd 01.10.2017
• Subjects: Adherence; Aging; Antidiabetics; Bisphosphonates; Clinical outcomes; Confidence intervals; Data processing; Discontinued; Drug abuse; Drug administration; Drugs; Extraction; Innovations; Medication adherence; Patient compliance; Pharmacy; Population studies; Research methodology; Statins
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2017.08.2054

OBJECTIVES: Drug-utilization studies applies different methods to various data types to describe medication-adherence. Comparison of results of these studies is difficult due to differences in the methods applied, data-sources and selected populations. This study, performed under the umbrella of Action-Group-Al on adherence of European-Innovation-Partnership on Active-and-Healthy-Aging, evaluates medication adherence and persistence to chronic therapies across different European settings applying a harmonized method of data extraction and analysis. METHODS: Information were retrieved from pharmacy-claims databases of three European countries: Spain (EpiChron-Cohort), Ireland (HSE-PCRS), Italy (Campania-LHU). Subjects aged >65 years, newly initiated antidiabetics, statins, bisphosphonates (ATC Ill-level) between 7/1/2010 and 12/31/2010 were identified and followed over 12-months. The first dispensing defined the index-date and treatment group. Main outcome measures was adherence (medication possession ratio, MPR) and persistence on index treatment. MPR <80% was considered as non-adherence. Subjects were defined as persistent until discontinuation (gap >60 days between two subsequent index treatment refill). All country-specific datasets were prepared employing a common data input model. Outcome measures were calculated for each country and then pooled using random effect models. RESULTS: Total number of subjects analyzed was 33,490. Pooled estimates: i) antidiabetics cohort: 30.33% of subjects with MPR<80% (95%confidence interval: [25.53; 35.60], 12=95%, p<0.0001); rates of non-persistence 46.80% (95% C.I.: [36.40; 57.49], 12=98.7%, p<0.0001); ii) statins cohort: 52.45% of subjects with MPR<80% (95% C.I.: [33.43; 70.79], 12=99.9%, p<0.0001); rates of non-persistence 55.63% (95% C.I.: [35.24; 74.29], 12=99.9%, p<0.0001); iii) bisphosphonates cohort: 61.35% of subjects with MPR<80% (95% C.I.: [52.83; 69.22], 12=97.5%, p<0.0001); rates of non-persistence 60.24% (95% C.I.: [45.35; 73.46], 12=99.2%, p<0.0001). CONCLUSIONS: Our study showed high degree of heterogeneity among countries in adherence and persistence rates. The extraction and aggregation of data into a common data model allowed to calculate the drug use parameters by means of a systematic and uniform approach.