Department of Economics, Brigham Young University, 183 FOB, Provo, UT 84602, USA.
Am J Manag Care. 2011 Feb;17(2):153-60.
To determine the association between prescription nonadherence and the health of older adults with 1 or more of 5 chronic conditions.
Analysis of the correlation between prescription nonadherence and the health of older adults.
Data were from a 7-year panel with information on healthcare encounters and prescriptions. We used fixed-effects Cox duration regression models and fixed-effects Poisson count regression models to control for time-invariant factors specific to each subject when examining the impact of nonadherence on time to an emergency department (ED) visit (Cox regression) or number of ED visits (Poisson count regression).
Nonadherence was associated with subsequent ED visits for hypertension, chronic heart disease, diabetes, and hypercholesterolemia. No significant short-term effects of nonadherence on chronic obstructive pulmonary disease (COPD) were detected. However, long-term effects of nonadherence (using the count regression model with lagged counts) were detected for COPD, as well as for hypertension, diabetes, and hypercholesterolemia.
Medicinal adherence was important for all 5 conditions analyzed here. A year of nonadherence had the same correlation with ED use as making an older adult 1 year older.
确定 1 种或多种 5 种慢性病患者处方不依从与老年人健康之间的关系。
分析处方不依从与老年人健康之间的相关性。
数据来自 7 年的面板,包括医疗保健就诊和处方信息。当研究不依从对急诊部(ED)就诊时间(Cox 回归)或 ED 就诊次数(泊松计数回归)的影响时,我们使用固定效应 Cox 持续回归模型和固定效应泊松计数回归模型,控制每个个体特有的、随时间不变的因素。
不依从与高血压、慢性心脏病、糖尿病和高胆固醇血症的后续 ED 就诊有关。未发现不依从对慢性阻塞性肺疾病(COPD)有短期显著影响。然而,COPD 以及高血压、糖尿病和高胆固醇血症的不依从的长期影响(使用滞后计数的计数回归模型)被检测到。
在分析的所有 5 种情况下,药物依从性都很重要。1 年的不依从与使老年人年长 1 岁对 ED 使用的相关性相同。