The Impact of Poor Medication Adherence on Clinical Outcomes and Health Resource Use in Hypertension and/or Dyslipidaemia: A Systematic Literature Review
Author(s)
Kengne AP1, Zhu L2, Li J3, Bhatia MK4, Atanasov P5, Ivanova E6, Briere JB6, Khan Z7
1South African Medical Research Council, Cape Town, South Africa, 2Amaris Counsulting, Barcelona, Spain, 3Amaris Counsulting, Shanghai, China, 4Amaris Consulting, Toronto, ON, Canada, 5Amaris Consulting, Barcelona, B, Spain, 6Servier International, Suresnes, 92, France, 7Zebgene LLC, Malvern, PA, USA
Presentation Documents
OBJECTIVES:
Poor medication adherence leads to suboptimal effectiveness of treatment for hypertension and dyslipidaemia, and high risk of occurrence of cardiovascular events. We aim to summarize evidence on the impact of poor medication adherence on clinical outcomes and health resource use (HRU) among patients with hypertension and/or dyslipidaemia. METHODS: Embase, MEDLINE and MEDLINE In-Process were searched from inception to 1 February 2022 supplemented by hand-searching of conference abstracts published during 2019-2021. Studies reporting clinical outcomes and HRU for patients showing poor adherence to anti-hypertensives and/or lipid-lowering medications were included. RESULTS: In total, 47 studies were included, most were retrospective in nature (n = 37) and conducted in USA (n = 16). The impact on clinical outcomes and HRU was reported in 33 and 19 studies, respectively. Most studies assessing the effect of anti-hypertensives showed a significant decrease in the BP among patients with good adherence (proportion of days covered [PDC] ≥80%; ∆ systolic BP at 6-month: -4.5 mmHg) compared to those with poor adherence (∆ systolic BP at 6-month: 1.15 mmHg). In patients with hyperlipidaemia, the reduction in LDL cholesterol (LDL-c) was significantly higher in patients with good adherence (∆LDL-c: -34.11 to -41.96 mg/dL) compared to those with poor adherence (∆LDL-c: -14.00 to -18.90 mg/dL). In terms of HRU, patients with poor adherence to lipid-lowering medications or anti-hypertensives showed higher risks of cardiovascular-related and all-cause hospitalisation (odd ratios ranging from 1.12 to 1.47) and higher annual inpatient days (average 1.18 more days) compared to good-adherence groups. Additionally, the total healthcare costs were 1.1–1.6 times higher in the low adherence group compared to high adherence. CONCLUSIONS: The findings of this review indicate that poor adherence is associated with poor clinical outcomes and increased HRU. Thus, there is a need to improve medication adherence in patients with hypertension and/or dyslipidaemia.Conference/Value in Health Info
2022-11, ISPOR Europe 2022, Vienna, Austria
Value in Health, Volume 25, Issue 12S (December 2022)
Code
PCR217
Topic
Patient-Centered Research
Topic Subcategory
Adherence, Persistence, & Compliance, Patient-reported Outcomes & Quality of Life Outcomes
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)