American researchers have aimed to measure the prevalence and impact of multiple adherence barriers in patients with poorly controlled cardiometabolic disease. To investigate links between patient factors, multiple barriers and claims-based adherence, information from a linked electronic health records and insurer claims dataset was used and analysed using modified Poisson regression models. It was found that 25.1% of the 1,069 patients (mean age: 61 years) included in the study had multiple adherence barriers, with forgetfulness and health beliefs occurring most commonly (31%, n=268). In comparison to patients with no barriers or only one barrier, those with multiple barriers were more likely to have the following characteristics:
- Non-white ethnic background (relative risk [RR] 1.57, 95% confidence interval [CI] 1.21 to 1.74)
- Single/unpartnered (RR 1.36, 95% CI 1.06 to 1.74)
- Use tobacco (RR 1.54, 95% CI 1.13 to 2.11),
- Reduced glycaemic control (RR 1.77, 95% CI 1.31 to 2.39)
Average medication adherence was decreased by 3.1% (95% CI −4.6%, −1.5%) with each additional barrier. The researchers therefore concluded that over a quarter of non-adherent patients with poorly controlled cardiometabolic disease experienced multiple barriers which impacted their medication adherence. This data may be useful in developing new interventions to help address non-adherence. The original research, published in the American Journal of Cardiology, can be viewed here.
Contributed by Australian Medication Safety Services Associate – Isabella Singh