Concurrent Adherence To Multiple Chronic Disease Medications: Examining The Behavior And Issues Concerning Its Measurement
type: CreativeWork
description: Objectives the objectives were to 1) examine adherence to multiple medications prescribed for a chronic disease (intra-disease multiple medication adherence) and that of multiple chronic diseases (inter-disease multiple medication adherence); 2) determine appropriate measurement paradigm from different intra-disease multiple medication adherence measurement approaches; 3) identify optimal cut-point for a dichotomized composite measure. Methods a retrospective study design was used. The subjects came from the marketscanâ® commercial claims and encounters data 2002-2003 and filled both sulfonylurea (su) and thiazolidinedione (tzd). Adherence was measured by proportion of days covered (pdc) over each period of 30 or 90 days and cumulatively. Random components from multivariate multilevel models were analyzed to examine multiple medication adherence relationships, including associations of evolutions of adherence. Survival analysis was performed on any-cause or diabetes-related emergency services (er) utilization. Concordance statistics were computed to compare different measurement approaches. Results intra-disease multiple medication analysis demonstrated strong and significant (p<0.05) relationships between overall adherence estimates for su and tzd and changes in adherence estimates over time. Patients who were receiving lipid or hypertension medications, or both in addition to su and tzd shostrong and significant (p<0.05) relationships between overall adherence to cross-disease medications or cross-disease adherence slope estimates. However, such results were not observed in diabetic subjects who were prescribed nitrates for angina. Each of six composite measures of intra-disease multiple medication adherence significantly predicted hazard (hazard ratio <1.0) of all-cause or any diabetes-related er utilization. Although each concordance statistic was significant (p<0.05), there were no differences among concordance statistics produced by these measurement approache…
abstract: Objectives the objectives were to 1) examine adherence to multiple medications prescribed for a chronic disease (intra-disease multiple medication adherence) and that of multiple chronic diseases (inter-disease multiple medication adherence); 2) determine appropriate measurement paradigm from different intra-disease multiple medication adherence measurement approaches; 3) identify optimal cut-point for a dichotomized composite measure. Methods a retrospective study design was used. The subjects came from the marketscanâ® commercial claims and encounters data 2002-2003 and filled both sulfonylurea (su) and thiazolidinedione (tzd). Adherence was measured by proportion of days covered (pdc) over each period of 30 or 90 days and cumulatively. Random components from multivariate multilevel models were analyzed to examine multiple medication adherence relationships, including associations of evolutions of adherence. Survival analysis was performed on any-cause or diabetes-related emergency services (er) utilization. Concordance statistics were computed to compare different measurement approaches. Results intra-disease multiple medication analysis demonstrated strong and significant (p<0.05) relationships between overall adherence estimates for su and tzd and changes in adherence estimates over time. Patients who were receiving lipid or hypertension medications, or both in addition to su and tzd shostrong and significant (p<0.05) relationships between overall adherence to cross-disease medications or cross-disease adherence slope estimates. However, such results were not observed in diabetic subjects who were prescribed nitrates for angina. Each of six composite measures of intra-disease multiple medication adherence significantly predicted hazard (hazard ratio <1.0) of all-cause or any diabetes-related er utilization. Although each concordance statistic was significant (p<0.05), there were no differences among concordance statistics produced by these measurement approache…
author: Basak, Ram Sankar
keywords: Association Of The Evolutions, Medication Adherence, Multiple Chronic Medications, Pdc Measures, Proportion Of Days Covered, Survival Analysis, Pharmacy and Pharmaceutical Sciences
date published: 2013-01-01T08:00:00Z
date modified: 2026-07-24T03:06:21Z
provider: University of Mississippi
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: University of Mississippi