OBJECTIVES: Evidence suggests that improving adherence to cardiovascular medications is essential to successful treatment. A real-world data analysis was conducted on patients treated with lipid-lowering or antihypertensive drugs to assess treatment adherence over the last 6 years, in a clinical practice setting in Italy.

METHODS: This is a retrospective analysis on the administrative databases of geographically distributed healthcare entities covering about 5.5 million patients. A monitoring system was deployed to evaluate discontinuation of cardiovascular therapies (lipid-lowering agents and antihypertensives) over the last 6-year period(2016-2021). Discontinuation was determined through the fail-to-refill methodology, mainly based on the date and dose coverage of all prescriptions received (with a 50% tolerance): if a patient maintained this coverage throughout the reference period (refill), he/she was considered adherent (non-discontinuation). Among the study population, demographic (age, gender) and clinical variable (presence of diabetes mellitus) were recorded.

RESULTS: A slight increase over time was found in the rate of adherence to lipid-lowering treatments, ranging from 76.6%-75.6% (2016-2017) to 78.4%-76.3% (2020-2021). Similarly, adherence to antihypertensive drugs ranged from 83.9%-83.1% (2016-2017) to 84.7%-83.4% (2020-2021). Over the years, among the patients treated for the two drug classes, the average age was 73-75 years in 2016-2017 period, and 69-71 years in 2020-2021. Throughout the whole temporal span, no fluctuations were noticed in gender distribution (48% and 46% males treated with lipid-lowering and antihypertensive drugs, respectively). During the entire period, patients with diabetes mellitus diagnosis were 29% and 19% of those receiving lipid-lowering and antihypertensive agents, respectively.

CONCLUSIONS: These data show that in the last 6 years, there has been no substantial increase in adherence to lipid-lowering and antihypertensive drugs, which remains largely below the recommended levels, especially for lipid-lowering therapy. Hence, further efforts are needed in the territorial pharmaceutical network for the identification and monitoring of non-adherent patients to drive them in the proper therapeutic pathway.