Evaluation of medication adherence in hypertension, dyslipidemia, and
diabetes using health insurance claims: a population-based cohort study
in Japan
Abstract
Purpose: Hypertension (HT), dyslipidemia (DL), and diabetes
mellitus (DM) are major risk factors for cardiovascular diseases.
Despite the wide availability of medications to reduce this risk, poor
adherence to medications remains an issue. The aim of this study is to
evaluate medication adherence of prevalent users in these disease
medications (HT, DL, DM) using claims data. Factors associated with
non-adherence were also examined. Methods: Of 7,538
participants of the Tsuruoka Metabolomics Cohort Study, 3,737(HT:
2,724, DL: 2,137, DM: 665) were identified as prevalent users of these
disease medications. Information on lifestyle was collected through a
questionnaire. Adherence was assessed by a proportion of days covered
(PDC) and participants with PDC ≥ 0.8 were defined as adherent.
Predictors of non-adherence were determined by performing multivariable
logistic regression. Results: Medication adherence differed by
medication groups. Those with DL-only showed the lowest adherence
(79.6%), followed by those with DM-only (81.7%) and those with HT-only
(89.8%). The associations were observed especially among those with no
comorbidities. Determinants associated with non-adherence in each
medication group were skipping breakfast and poor understanding of
medications among those with HT, females, having comorbidities, having
the medical history of stroke, and drinking habit among those with DL,
and skipping breakfast among those with DM. Conclusion: While
participants showed high medication adherence, differences were observed
across medication groups. The identified predictors of non-adherence
could help target those in need of adherence support.