Relationship between medication compliance and medical outcomes

relationship between medication compliance and medical outcomes

As the amount of literature addressing the adherence-outcomes link was to which patients take medications as prescribed by their healthcare. Identifying the negative health outcomes associat ed with poor compliance with prescribed drugs could save the health care system an enormous amount of. 1Yale University School of Medicine, New Haven, CT, USA; 2West Virginia University, Morgantown,WV, USA; 3Sanofi-Aventis, Paris, Results: Medication compliance and medication persistence . sensitivity testing or link to outcome) [ 9].

Relationship between medication compliance and medical outcomes.

Little is known however, about the complex relationships between medication and treatment variables and drinking outcomes. The present paper reports on the differential impact of medication adherence and treatment factors on drinking outcomes.

Data derived from the COMBINE Study was used to investigate the interrelationships between medication adherence, combination treatments and drinking outcomes. Methods Twelve hundred and twenty-six patients were randomized to one of eight different combination treatments involving two medications - naltrexone and acamprosate and placebo, and two behavioral treatments - medical management MM and combined behavioral intervention CBI.

Two primary drinking outcomes were percent days abstinent PDA and time to first heavy drinking day. Medication adherence was defined as a proportion that reflects the number of pills taken by the maximum number of pills expected to be taken over the course of the trial.

A generalized linear mixed model was used to estimate the effects of adherence on PDA while proportional hazards model was used to examine similar co-variate effects on time to first heavy drinking day.

CBI did not add any such advantage to naltrexone-treated patients. Conclusions CBI might serve a protective function for nonadherers in the placebo group; the median relapse time was reduced when these nonadherers were exposed to the alcohol specialty intervention.

CBI offered little additional benefit to nonadherers in the naltrexone group. Among nonadherers in the naltrexone group, relapse rates appear to be more a function of inadequate exposure to the active medication and less influenced by CBI. In addition, behavioral treatment employed in combination with medication can facilitate medication adherence.

Behavioral therapy can be used to address patient concerns related to adverse reactions to the medication while improving coping skills, building supportive relationships for taking medication for chronic conditions, and strengthening motivation to change Carroll, These factors are not only relevant to improving medication adherence but to sustaining the benefits of change as well.

More is known about the impact of medication adherence on treatment outcome in naltrexone studies than in acamprosate trials Pettinati, Specifically, several placebo-controlled naltrexone studies have demonstrated a significant relationship between good adherence to medication and behavioral treatment regimens and successful treatment outcomes Baros et al.

For example, Volpicelli et al.

relationship between medication compliance and medical outcomes

These authors also found significant differences between naltrexone and placebo patients in drinking outcomes only among patients that took their medication regularly. In contrast, among individuals with low medication adherence, no significant differences were observed between naltrexone and placebo patients on drinking measures.

Associating Medication Adherence With Improved Outcomes: A Systematic Literature Review

These differences in outcomes between placebo and naltrexone-treated patients appeared to be moderated by medication adherence. Similar findings have been reported by Cramer and her colleagues Am J Pharm Benefits. Some diseases had stronger relationships than others, supporting the need for disease state—specific investigations to characterize the strength of the adherence-outcomes relationship.

As the amount of literature addressing the adherence-outcomes link was limited, further research is needed on this clinically important topic. Increased drug utilization for managing chronic diseases, coupled with the potential for increasingly prolonged treatment, elevates the criticality of maintaining comprehensive medication management, of which adherence is a major part. Within the published literature, adherence to a medication regimen is generally defi ned as the extent to which patients take medications as prescribed by their healthcare providers,3 or the level of patient participation in an agreed-on medication regimen.

Despite the established role of adherence-related education and monitoring in clinical research and practice settings, the extent to which different levels of adherence ultimately impact patient outcomes is a poorly understood phenomenon, due in part to the complexities inherent in designing studies with this research question in mind.

There was a stronger relationship between adherence and outcomes in chronic diseases compared with acute diseases risk difference of 0. To address this issue, we conducted a systematic literature review to evaluate the strength of evidence within the literature for selected types of cardiovascular disease CVDand mental health, metabolic, neurologic, and pulmonary disorders associated with substantial disease burden in the United States,8 with consideration of clinical, utilization, and economic outcomes.

This analysis also allowed the opportunity to identify gaps in the literature where there is a need for additional research. The search was limited to English-language articles that evaluated one of the disease states of interest and the association between adherence and outcomes. Articles published between and May were included.

Associating Medication Adherence With Improved Outcomes: A Systematic Literature Review

Two independent reviewers were utilized to evaluate the articles for study selection. Any scoring discrepancies were resolved between the reviewers. Data Extraction and Analysis The 12 identified disease states were divided into 5 broad disease categories: The overall relationship between medication adherence and clinical, economic, and utilization outcomes was evaluated, as well as across all individual disease states.

Since many studies evaluated and reported multiple outcomes as well as multiple disease states, the results were based on the total number of outcomes, rather than the total number of studies.

relationship between medication compliance and medical outcomes