IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v19y2022i9p5692-d810379.html
   My bibliography  Save this article

Multiple Medication Adherence and Related Outcomes in Community-Dwelling Older People on Chronic Polypharmacy: A Retrospective Cohort Study on Administrative Claims Data

Author

Listed:
  • Carlotta Franchi

    (Laboratory of Pharmacoepidemiology and Human Nutrition, Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156 Milan, Italy)

  • Monica Ludergnani

    (Direzione Sanitaria—Centro Cardiologico Monzino (I.R.C.C.S.), 20138 Milan, Italy)

  • Luca Merlino

    (Direzione Sanitaria—Centro Cardiologico Monzino (I.R.C.C.S.), 20138 Milan, Italy)

  • Alessandro Nobili

    (Laboratory of Pharmacoepidemiology and Human Nutrition, Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156 Milan, Italy)

  • Ida Fortino

    (Directorate General for Health, Lombardy Region, 20124 Milan, Italy)

  • Olivia Leoni

    (Directorate General for Health, Lombardy Region, 20124 Milan, Italy)

  • Ilaria Ardoino

    (Laboratory of Pharmacoepidemiology and Human Nutrition, Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156 Milan, Italy)

Abstract

Poor medication adherence compromises treatment efficacy and adversely affects patients’ clinical outcomes. This study aims to assess (1) multiple medication adherence to the most common drug classes chronically prescribed to older people, (2) the factors associated, and (3) the clinical outcomes. This retrospective cohort study included 122,655 community-dwelling patients aged 65–94 years old, newly exposed to chronic polypharmacy, and recorded in the Lombardy Region (northern Italy) administrative database from 2016 to 2018. Multiple medication adherence was assessed for drugs for diabetes, antithrombotics, antihypertensives, statins, and bisphosphonates, by calculating the daily polypharmacy possession ratio (DPPR). One-year mortality, nursing home, emergency department (ED), and hospital admission rates were calculated for 2019. The most prescribed drugs were antihypertensives (89.0%). The mean (std.dev) DPPR was 82.9% (15.6). Being female (OR = 0.85, 95%CI: 0.84–0.86), age ≥85 years (OR = 0.77, 95%CI: 0.76–0.79), and multimorbidity (≥4 diseases, OR = 0.88, 95%CI: 0.86–0.90) were associated with lower medication adherence. A higher DPPR was associated with clinical outcomes—in particular, improved survival (HR = 0.93 for 10/100-point increase, 95%CI: 0.92–0.94) and lower incidence in nursing home admissions (SDHR = 0.95, 95%CI: 0.93–0.97). Adherence to the most common chronic drugs co-prescribed to the older population was high. Better multiple medication adherence was associated with better clinical outcomes.

Suggested Citation

  • Carlotta Franchi & Monica Ludergnani & Luca Merlino & Alessandro Nobili & Ida Fortino & Olivia Leoni & Ilaria Ardoino, 2022. "Multiple Medication Adherence and Related Outcomes in Community-Dwelling Older People on Chronic Polypharmacy: A Retrospective Cohort Study on Administrative Claims Data," IJERPH, MDPI, vol. 19(9), pages 1-12, May.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:9:p:5692-:d:810379
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/19/9/5692/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/19/9/5692/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Ospina, Raydonal & Ferrari, Silvia L.P., 2012. "A general class of zero-or-one inflated beta regression models," Computational Statistics & Data Analysis, Elsevier, vol. 56(6), pages 1609-1623.
    2. Daniel Gomes & Ana Isabel Placido & Rita Mó & João Lindo Simões & Odete Amaral & Isabel Fernandes & Fátima Lima & Manuel Morgado & Adolfo Figueiras & Maria Teresa Herdeiro & Fátima Roque, 2019. "Daily Medication Management and Adherence in the Polymedicated Elderly: A Cross-Sectional Study in Portugal," IJERPH, MDPI, vol. 17(1), pages 1-13, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Manuela Casula & Ilaria Ardoino & Carlotta Franchi, 2023. "Appropriateness of the Prescription and Use of Medicines: An Old Concept but More Relevant than Ever," IJERPH, MDPI, vol. 20(3), pages 1-5, February.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Enrico Bergamini & Georg Zachmann, 2020. "Exploring EU’s Regional Potential in Low-Carbon Technologies," Sustainability, MDPI, vol. 13(1), pages 1-28, December.
    2. Gourieroux, Christian & Lu, Yang, 2019. "Least impulse response estimator for stress test exercises," Journal of Banking & Finance, Elsevier, vol. 103(C), pages 62-77.
    3. Guillermo Martínez-Flórez & Artur J. Lemonte & Germán Moreno-Arenas & Roger Tovar-Falón, 2022. "The Bivariate Unit-Sinh-Normal Distribution and Its Related Regression Model," Mathematics, MDPI, vol. 10(17), pages 1-26, August.
    4. Lucio Masserini & Matilde Bini & Monica Pratesi, 2017. "Effectiveness of non-selective evaluation test scores for predicting first-year performance in university career: a zero-inflated beta regression approach," Quality & Quantity: International Journal of Methodology, Springer, vol. 51(2), pages 693-708, March.
    5. Harald Oberhofer & Michael Pfaffermayr, 2014. "Two-Part Models for Fractional Responses Defined as Ratios of Integers," Econometrics, MDPI, vol. 2(3), pages 1-22, September.
    6. Jinji, Naoto & Zhang, Xingyuan & Haruna, Shoji, 2019. "Does a firm with higher Tobin’s q prefer foreign direct investment to foreign outsourcing?," The North American Journal of Economics and Finance, Elsevier, vol. 50(C).
    7. Ricardo Ocaña-Riola & Carmen Pérez-Romero & Mª Isabel Ortega-Díaz & José Jesús Martín-Martín, 2021. "Multilevel Zero-One Inflated Beta Regression Model for the Analysis of the Relationship between Exogenous Health Variables and Technical Efficiency in the Spanish National Health System Hospitals," IJERPH, MDPI, vol. 18(19), pages 1-18, September.
    8. Silvia Noirjean & Mario Biggeri & Laura Forastiere & Fabrizia Mealli & Maria Nannini, 2023. "Estimating causal effects of community health financing via principal stratification," Statistical Methods & Applications, Springer;Società Italiana di Statistica, vol. 32(4), pages 1317-1350, October.
    9. Carlos Rojas & Bernardo Riffo & Ernesto Guerra, 2023. "Word Retrieval After the 80s: Evidence From Specific and Multiple Words Naming Tasks," SAGE Open, , vol. 13(2), pages 21582440231, May.
    10. Ehsan Bahrami Samani & Elham Tabrizi, 2023. "Joint Linear Modeling of Mixed Data and Its Application to Email Analysis," Sankhya B: The Indian Journal of Statistics, Springer;Indian Statistical Institute, vol. 85(1), pages 175-209, May.
    11. Cristine Rauber & Francisco Cribari-Neto & Fábio M. Bayer, 2020. "Improved testing inferences for beta regressions with parametric mean link function," AStA Advances in Statistical Analysis, Springer;German Statistical Society, vol. 104(4), pages 687-717, December.
    12. Aaron J. Staples & Trey Malone & J. Robert Sirrine, 2021. "Hopping on the localness craze: What brewers want from state‐grown hops," Managerial and Decision Economics, John Wiley & Sons, Ltd., vol. 42(2), pages 463-473, March.
    13. Murilo Wohlgemuth & Carlos Ernani Fries & Ângelo Márcio Oliveira Sant’Anna & Ricardo Giglio & Diego Castro Fettermann, 2020. "Assessment of the technical efficiency of Brazilian logistic operators using data envelopment analysis and one inflated beta regression," Annals of Operations Research, Springer, vol. 286(1), pages 703-717, March.
    14. Reboul, E. & Guérin, I. & Nordman, C.J., 2021. "The gender of debt and credit: Insights from rural Tamil Nadu," World Development, Elsevier, vol. 142(C).
    15. Masserini, Lucio & Bini, Matilde & Lorenzoni, Valentina, 2024. "The effect of pricing policies on students’ use of university canteens," Socio-Economic Planning Sciences, Elsevier, vol. 94(C).
    16. Maria dos Anjos Dixe & Joana Pinho & Filipa Pereira & Henk Verloo & Carla Meyer-Massetti & Sónia Gonçalves Pereira, 2023. "Patterns of Medication Management and Associated Medical and Clinical Features among Home-Dwelling Older Adults: A Cross-Sectional Study in Central Portugal," IJERPH, MDPI, vol. 20(3), pages 1-12, January.
    17. Diego Ramos Canterle & Fábio Mariano Bayer, 2019. "Variable dispersion beta regressions with parametric link functions," Statistical Papers, Springer, vol. 60(5), pages 1541-1567, October.
    18. Yury R. Benites & Vicente G. Cancho & Edwin M. M. Ortega & Roberto Vila & Gauss M. Cordeiro, 2022. "A New Regression Model on the Unit Interval: Properties, Estimation, and Application," Mathematics, MDPI, vol. 10(17), pages 1-17, September.
    19. Francisco Cribari-Neto & Sadraque E.F. Lucena, 2015. "Nonnested hypothesis testing in the class of varying dispersion beta regressions," Journal of Applied Statistics, Taylor & Francis Journals, vol. 42(5), pages 967-985, May.
    20. Xiong, Qizhou, 2015. "Censored Fractional Response Model: Estimating Heterogeneous Relative Risk Aversion of European Households," IWH Discussion Papers 11/2015, Halle Institute for Economic Research (IWH).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:19:y:2022:i:9:p:5692-:d:810379. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.