Medication Adherence and Persistence of Open-Angle Glaucoma Patients in Korea: A Retrospective Study Using National Health Insurance Claims Data
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Source
2.2. Study Population
2.3. Outcomes
2.4. Statistical Analysis
3. Results
3.1. Adherence, Persistence, and Demographic Characteristics
3.2. Logistic Regression Analysis for Adherence and Persistence
3.3. Adherence, Persistence, and Characteristics by Index Medication
4. Discussion
4.1. Adherence and Persistence in Korea
4.2. Factors Associated with Adherence and Persistence
4.3. Limitations and Strengths
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
Variable | Medication Possession Ratio (MPR) 1,2 | Duration of Therapy 1,2 | ||
---|---|---|---|---|
Univariate | Multivariate | Univariate | Multivariate | |
Age, years | ||||
20–59 | - | - | - | - |
≥60 | 0.059 (0.034, 0.084) ‡ | 0.049 (0.023, 0.076) ‡ | 0.046 (0.015, 0.078) † | 0.036 (0.005, 0.067) * |
Type of index medication | ||||
Beta-blockers | - | - | - | - |
Prostaglandins | 0.111 (0.078, 0.144) ‡ | 0.110 (0.077, 0143) ‡ | 0.074 (0.034, 0.115) ‡ | 0.074 (0.033, 0.115) ‡ |
Sex | ||||
Male | - | - | - | - |
Female | 0.054 (0.030, 0.077) ‡ | 0.056 (0.032, 0.079) ‡ | 0.070 (0.042, 0.098) ‡ | 0.073 (0.045, 0.102) ‡ |
CCI | ||||
0 | - | - | ||
≥1 | 0.012 (−0.011, 0.035) | −0.003 (−0.031, 0.026) | ||
Medical institution | ||||
Primary care | - | - | - | - |
Secondary or tertiary care | 0.148 (0.117, 0.179) ‡ | 0.151 (0.120, 0.182) ‡ | 0.159 (0.121, 0.197) ‡ | 0.162 (0.124, 0.200) ‡ |
Hypertension | ||||
No | - | - | - | |
Yes | 0.025 (0.002, 0.048) * | 0.008 (−0.017, 0.032) | 0.021 (−0.008, 0.050) | |
Diabetes | ||||
No | - | - | ||
Yes | −0.001 (−0.028, 0.026) | −0.009 (−0.042, 0.025) | ||
Stroke | ||||
No | - | - | ||
Yes | 0.005 (−0.047, 0.058) | −0.017 (−0.081, 0.048) |
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Variable | Total (n = 14,648) | Adherence Status 1 | Persistence Status 2 | ||||
---|---|---|---|---|---|---|---|
Adherent (n = 3118) | Nonadherent (n = 11,530) | p-Value 3 | Persistent (n = 4481) | Nonpersistent (n = 10,167) | p-Value 3 | ||
MPR (%), mean ± SD 4 | 48.8 ± 30.5 | 93.4 ± 6.6 | 36.7 ± 22.1 | <0.0001 | 84.0 ± 16.2 | 33.3 ± 21.0 | <0.0001 |
Duration of therapy (days), mean ± SD 5 | 357.2 ± 276.2 | 706.1 ± 95.2 | 262.8 ± 229.4 | <0.0001 | 722.3 ± 17.6 | 196.3 ± 158.5 | <0.0001 |
Age, years | |||||||
20–59 | 4621 (31.5) | 890 (19.3) | 3731 (80.7) | <0.0001 | 1337 (28.9) | 3284 (71.1) | 0.0031 |
≥60 | 10,027 (68.5) | 2228 (22.2) | 7799 (77.8) | 3144 (31.4) | 6883 (68.6) | ||
Type of index medication | |||||||
Beta-blockers | 2056 (14.0) | 363 (17.7) | 1693 (82.3) | <0.0001 | 572 (27.8) | 1484 (72.2) | 0.0033 |
Prostaglandin analogs | 12,592 (86.0) | 2755 (21.9) | 9837 (78.1) | 3909 (31.0) | 8683 (69.0) | ||
Sex | |||||||
Male | 7027 (48.0) | 1435 (20.4) | 5592 (79.6) | 0.0141 | 2034 (28.9) | 4993 (71.1) | <0.0001 |
Female | 7621 (52.0) | 1683 (22.1) | 5938 (77.9) | 2447 (32.1) | 5174 (67.9) | ||
CCI | |||||||
0 | 6567 (44.8) | 1340 (20.4) | 5227 (79.6) | 0.0188 | 2021 (30.8) | 4546 (69.2) | 0.6633 |
≥1 | 8081 (55.2) | 1778 (22.0) | 6303 (78.0) | 2460 (30.4) | 5621 (69.6) | ||
Medical institution | |||||||
Primary care | 12,181 (83.2) | 2391 (19.6) | 9790 (80.4) | <0.0001 | 3592 (29.5) | 8589 (70.5) | <0.0001 |
Secondary or tertiary care | 2467 (16.8) | 727 (29.5) | 1740 (70.5) | 889 (36.0) | 1578 (64.0) | ||
Hypertension | |||||||
No | 7986 (54.5) | 1664 (20.8) | 6322 (79.2) | 0.1454 | 2419 (30.3) | 5567 (69.7) | 0.3872 |
Yes | 6662 (45.5) | 1454 (21.8) | 5208 (78.2) | 2062 (30.9) | 4600 (69.1) | ||
Diabetes | |||||||
No | 11,082 (75.7) | 2343 (21.1) | 8739 (78.9) | 0.4536 | 3418 (23.3) | 7664 (69.2) | 0.2440 |
Yes | 3566 (24.3) | 775 (21.7) | 2791 (78.3) | 1063 (29.8) | 2503 (70.2) | ||
Stroke | |||||||
No | 13,906 (94.9) | 2954 (21.2) | 10,952 (78.8) | 0.5772 | 4269 (30.7) | 9637 (69.3) | 0.2204 |
Yes | 742 (5.1) | 164 (22.1) | 578 (77.9) | 212 (28.6) | 530 (71.4) |
Variable | Adherence Status 1 | Persistence Status 2 | ||
---|---|---|---|---|
Univariate | Multivariate | Univariate | Univariate | |
Age, years | ||||
20–59 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
≥60 | 1.20 (1.10, 1.31) ‡ | 1.21 (1.10, 1.32) ‡ | 1.12 (1.04, 1.21) † | 1.11 (1.03, 1.20) † |
Type of index medication | ||||
Beta-blockers | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
Prostaglandins | 1.31 (1.16, 1.47) ‡ | 1.27 (1.13, 1.44) ‡ | 1.17 (1.05, 1.30) † | 1.16 (1.05, 1.29) † |
Sex | ||||
Male | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
Female | 1.10 (1.02, 1.20) * | 1.12 (1.04, 1.22) † | 1.16 (1.08, 1.25) ‡ | 1.17 (1.09, 1.26) ‡ |
CCI | ||||
0 | 1 (reference) | 1 (reference) | 1 (reference) | |
≥1 | 1.10 (1.02, 1.19) * | 1.00 (0.92, 1.10) | 0.98 (0.92, 1.06) | |
Medical institution | ||||
Primary care | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
Secondary or tertiary care | 1.71 (1.55, 1.89) ‡ | 1.73 (1.57, 1.91) ‡ | 1.35 (1.23, 1.48) ‡ | 1.36 (1.24, 1.49) ‡ |
Hypertension | ||||
No | 1 (reference) | 1 (reference) | ||
Yes | 1.06 (0.98, 1.15) | 1.03 (0.96, 1.11) | ||
Diabetes | ||||
No | 1 (reference) | 1 (reference) | ||
Yes | 1.04 (0.95, 1.14) | 0.95 (0.88, 1.03) | ||
Stroke | ||||
No | 1 (reference) | 1 (reference) | ||
Yes | 1.05 (0.88, 1.26) | 0.903 (0.77, 1.06) |
Variable | MPR (%), Mean ± SD 1 | p-Value 2 | Duration of Therapy (Days), Mean ± SD 3 | p-Value 2 |
---|---|---|---|---|
Total patients (n = 14,648) | 48.8 ± 30.5 | - | 357.2 ± 276.2 | - |
Age, years | ||||
20–59 | 46.8 ± 30.4 | <0.0001 | 346.0 ± 274.3 | 0.0009 |
≥60 | 49.7 ± 30.6 | 362.3 ± 276.9 | ||
Type of index medication | ||||
Beta-blockers | 44.3 ± 30.5 | <0.0001 | 334.9 ± 275.9 | <0.0001 |
Prostaglandin analogs | 49.5 ± 30.5 | 360.8 ± 276.1 | ||
Sex | ||||
Male | 47.4 ± 30.6 | <0.0001 | 334.2 ± 274.6 | <0.0001 |
Female | 50.0 ± 30.5 | 369.2 ± 277.1 | ||
CCI | ||||
0 | 48.4 ± 30.3 | 0.2419 | 357.7 ± 276.7 | 0.8481 |
≥1 | 49.0 ± 30.7 | 256.8 ± 275.8 | ||
Medical institution | ||||
Primary care | 47.5 ± 30.2 | <0.0001 | 347.1 ± 276.7 | <0.0001 |
Secondary or tertiary care | 55.1 ± 31.3 | 409.8 ± 268.1 | ||
Hypertension | ||||
No | 48.2 ± 47.5 | 0.0160 | 353.8 ± 276.1 | 0.0996 |
Yes | 49.4 ± 30.4 | 361.3 ± 276.3 | ||
Diabetes | ||||
No | 48.8 ± 30.5 | 0.9215 | 357.9 ± 276.5 | 0.5604 |
Yes | 48.8 ± 30.6 | 354.9 ± 275.2 | ||
Stroke | ||||
No | 48.8 ± 30.5 | 0.8218 | 357.5 ± 276.5 | 0.5742 |
Yes | 49.0 ± 30.9 | 351.6 ± 269.9 |
Variable | Total (n = 14,648) | Type of Index Medication | ||
---|---|---|---|---|
Prostaglandins (n = 12,592) | Beta-Blockers (n = 2056) | p-Value 1 | ||
MPR (%), mean ± SD 2 | 48.8 ± 30.5 | 49.5 ± 30.5 | 44.3 ± 30.5 | <0.0001 |
Adherence status, n (%) 3 | ||||
Adherent | 3118 (21.3) | 2755 (21.9) | 363 (17.7) | <0.0001 |
Nonadherent | 11,530 (78.7) | 9837 (78.1) | 1693 (82.3) | |
Duration of therapy (days), mean ± SD 4 | 357.2 ± 276.2 | 360.8 ± 276.1 | 334.9 ± 275.9 | <0.0001 |
Persistence status, n (%) 5 | ||||
Persistent | 4481 (30.6) | 3909 (31.0) | 572 (27.8) | 0.0033 |
Nonpersistent | 10,167 (69.4) | 8683 (69.0) | 1484 (72.2) | |
Age, years | ||||
20–59 | 4621 (31.5) | 3935 (85.2) | 686 (14.8) | 0.0556 |
≥60 | 10,027 (68.5) | 8657 (86.3) | 1370 (13.7) | |
Sex | ||||
Male | 7027 (48.0) | 6186 (88.0) | 841 (12.0) | <0.0001 |
Female | 7621 (52.0) | 6406 (84.1) | 1215 (15.9) | |
CCI | ||||
0 | 6567 (44.8) | 5603 (85.3) | 964 (14.7) | 0.0433 |
≥1 | 8081 (55.2) | 6989 (86.5) | 1092 (13.5) | |
Medical institution | ||||
Primary care | 12,181 (83.2) | 10,370 (85.1) | 1811 (14.9) | <0.0001 |
Secondary or tertiary care | 2467 (16.8) | 2222 (90.1) | 245 (9.9) | |
Hypertension | ||||
No | 7986 (54.5) | 6875 (86.1) | 1111 (13.9) | 0.6356 |
Yes | 6662 (45.5) | 5717 (85.8) | 945 (14.2) | |
Diabetes | ||||
No | 11,082 (75.7) | 9511 (85.8) | 1571 (14.2) | 0.3895 |
Yes | 3566 (24.3) | 3081 (86.4) | 485 (13.6) | |
Stroke | ||||
No | 13,906 (94.9) | 11,941 (85.9) | 1965 (14.1) | 0.1538 |
Yes | 742 (5.1) | 651 (87.7) | 91 (12.3) |
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Jang, Y.; Jee, D.; Lee, D.; Choi, N.-K.; Bae, S. Medication Adherence and Persistence of Open-Angle Glaucoma Patients in Korea: A Retrospective Study Using National Health Insurance Claims Data. Int. J. Environ. Res. Public Health 2021, 18, 4106. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18084106
Jang Y, Jee D, Lee D, Choi N-K, Bae S. Medication Adherence and Persistence of Open-Angle Glaucoma Patients in Korea: A Retrospective Study Using National Health Insurance Claims Data. International Journal of Environmental Research and Public Health. 2021; 18(8):4106. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18084106
Chicago/Turabian StyleJang, Yunjeong, Donghyun Jee, Donghwan Lee, Nam-Kyong Choi, and SeungJin Bae. 2021. "Medication Adherence and Persistence of Open-Angle Glaucoma Patients in Korea: A Retrospective Study Using National Health Insurance Claims Data" International Journal of Environmental Research and Public Health 18, no. 8: 4106. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18084106