Interrupted time series analysis on first cardiovascular disease hospitalization for adherence to lipid-lowering therapy.


Journal

Pharmacoepidemiology and drug safety
ISSN: 1099-1557
Titre abrégé: Pharmacoepidemiol Drug Saf
Pays: England
ID NLM: 9208369

Informations de publication

Date de publication:
02 2020
Historique:
received: 14 05 2019
revised: 04 10 2019
accepted: 11 10 2019
pubmed: 4 12 2019
medline: 23 1 2021
entrez: 3 12 2019
Statut: ppublish

Résumé

We analysed lipid-lowering medication adherence before and after the first hospitalization for cardiovascular disease (CVD) to explore the influence hospitalization has on patient medication adherence. We extracted a sub-cohort for analysis from 313,207 patients who had primary CVD risk assessment. Adherence was assessed as proportion of days covered (PDC) ≥ 80% based on community dispensing records. Adherence in the 4 quarters (360 days) before the first CVD hospitalization and 8 quarters (720 days) after hospital discharge was assessed for each individual in the sub-cohort. An interrupted time series design using generalized estimating equations was applied to compare the differences of population-level medication adherence rates before and after the first CVD hospitalization. Overall, a significant improvement in medication adherence rate from before to after the hospitalization was observed (odds ratio (OR) 2.49 [1.74-3.57]) among the 946 patients included in the analysis. Patients having diabetes history had a higher OR of adherence before the hospitalization than patients without diabetes (1.50 [1.03-2.22]) but no significant difference after the hospitalization (OR 1.13 [0.89-1.43]). Before the first hospitalization, we observed that quarterly medication adherence rate was steady at around 55% (OR 0.97 [0.93-1.01), whereas the trend in adherence over the post-hospitalization period decreased significantly per quarter (OR 0.97 [0.94-0.99]). Patients were more likely to adhere to lipid-lowering therapy after experiencing a first CVD hospitalization. The change in medication adherence rate is consistent with patients having heightened perception of disease severity following the hospitalization.

Identifiants

pubmed: 31788906
doi: 10.1002/pds.4916
doi:

Substances chimiques

Hypolipidemic Agents 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

150-160

Informations de copyright

© 2019 John Wiley & Sons, Ltd.

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Auteurs

Feiyu Hu (F)

School of Computer Science, University of Auckland, Auckland, New Zealand.

Jim Warren (J)

School of Computer Science, University of Auckland, Auckland, New Zealand.

Daniel J Exeter (DJ)

School of Population Health, University of Auckland, Auckland, New Zealand.

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