The relationship between patient medication adherence and following preventive medicine recommendation

Background: To study the relationship between adherence to chronic medications and adherence to preventive medicine recommendations among persons with diabetes mellitus and hypertension. Methods: Data were collected from the Clalit database included all members of Clalit aged 50 to 74 years, diagnosed with diabetes mellitus or hypertension before 2016 and treated with at least 1 medication (statins hypotensive or antidiabetic drugs) during 2017. We analyzed all the monthly prescriptions that were filled during 2017. We determined personal adherence rates by calculating each individual’s average adherence rate to all the prescribed medications. Adherence rates were stratified by quintiles. We checked whether each person included followed the Israeli recommendations for influenza vaccine, colon cancer screening, and mammography. Results: Of 268,792 persons, 81.1% had hypertension, and 59.5% had diabetes; 40.6% had diabetes and hypertension. The mean age was 63.7 years; 50.6% were men. The mean number of medications used was 2.2 6 1.1. An adherence rate of ≤20% was found in 4.2%, and >80% in 42.5%. Overall, 59.6% had received an influenza vaccine, 68.0% had undergone colon cancer screening, and 75.2% of the women had undergone mammography. Increased adherence to medications was associated with increased adherence to preventive recommendations. For persons in the study cohort, adjusted odds ratios comparing the highest to the lowest quintile of medication adherence were 1.52 (1.46–1.59) for influenza vaccine, 1.59 (1.53–1.66) for colon cancer screen, and 1.35 (1.27–1.44) for mammography. Discussion: A positive association was observed between adherence to chronic medications and adherence to preventive medicine among persons with hypertension and diabetes.