利用健康保险索赔评估高血压、血脂异常和糖尿病患者的用药依从性:日本基于人群的队列研究。

IF 2.4 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pharmacoepidemiology and Drug Safety Pub Date : 2024-08-01 DOI:10.1002/pds.5855
Minako Matsumoto, Sei Harada, Harufumi Ikuta, Miho Iida, Suzuka Kato, Mizuki Sata, Takuma Shibuki, Yoshiki Ishibashi, Naoko Miyagawa, Moeko Hisamatsu, Aya Hirata, Kazuyo Kuwabara, Ayano Takeuchi, Daisuke Sugiyama, Sayo Suzuki, Tomonori Nakamura, Tomonori Okamura, Toru Takebayashi
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引用次数: 0

摘要

目的:高血压(HT)、血脂异常(DL)和糖尿病(DM)是心血管疾病的主要风险因素。尽管有多种药物可降低这一风险,但用药依从性差仍是一个问题。本研究的目的是利用理赔数据评估这些疾病(高血压、糖尿病、高血脂)常用药使用者的用药依从性。同时还研究了与不坚持用药相关的因素:在鹤冈代谢组学队列研究的 7538 名参与者中,有 3693 人(HT:2702 人,DL:2112 人,DM:661 人)被确定为这些疾病药物的普遍使用者。通过问卷调查收集了有关生活方式的信息。依从性通过覆盖天数比例(PDC)进行评估,PDC≥0.8的参与者被定义为依从者。通过多变量逻辑回归确定不坚持用药的预测因素:结果:用药依从性因治疗状况而异。在无并发症的患者中,仅接受 HT 治疗的患者依从性最高(90.2%),其次是仅接受 DM 治疗的患者(81.2%)和仅接受 DL 治疗的患者(80.8%)。在各用药组别中,与不依从性相关的因素有:服用高血压药物者不吃早餐和对药物理解不深;服用糖尿病药物者为女性、有合并症、有心脏病史和有饮酒习惯;服用糖尿病药物者睡眠质量好和不吃早餐:虽然参与者的用药依从性较高,但不同用药组之间存在差异。已确定的不坚持用药的预测因素有助于锁定需要坚持用药支持的人群。
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Evaluation of Medication Adherence Among Prevalent Users in Hypertension, Dyslipidemia, and Diabetes Using Health Insurance Claims: A Population-Based Cohort Study in Japan.

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 7538 participants of the Tsuruoka Metabolomics Cohort Study, 3693 (HT: 2702, DL: 2112, DM: 661) 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 treatment status. Among those without comorbidities, those with HT-only showed the highest adherence (90.2%), followed by those with DM-only (81.2%) and those with DL-only (80.8%). Factors associated with non-adherence in each medication group were skipping breakfast and poor understanding of medications among those with HT medications, females, having comorbidities, having a history of heart disease, and drinking habit among those with DL medications, and good sleep quality and skipping breakfast among those with DM medications.

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.

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来源期刊
CiteScore
4.80
自引率
7.70%
发文量
173
审稿时长
3 months
期刊介绍: The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report. Particular areas of interest include: design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology; comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world; methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology; assessments of harm versus benefit in drug therapy; patterns of drug utilization; relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines; evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.
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