|
KMID : 0370220170610030135
|
|
Yakhak Hoeji
2017 Volume.61 No. 3 p.135 ~ p.146
|
|
|
Effect of the Clinic-based Chronic Disease Management Program on the Appropriateness of Medication Adherence and Persistence in Hypertension Patients in Korea
|
|
Kim Jung-Ae
Lee Eui-Kyung
|
|
|
Abstract
|
|
|
|
The Clinic-based Chronic Disease Management Program (CDMP), a multi-level intervention including co-payment reduction and physician incentives, was introduced in 2012 in Korea to improve blood pressure and glycemic control by strengthening the clinic’s function as primary care institutions in managing hypertension and diabetes. A pre-post retrospective study was conducted using insurance-claims cohort data from 2010 to 2013 to evaluate CDMP’s effect on the appropriateness of medication adherence and persistence in hypertension patients. Hypertension patients were selected as CDMP group, while dyslipidemia patients were the control group. Study groups were further categorized as shifters to clinic or non-shifters to clinic on the basis of whether hospital use changed to clinic use during the study period. Adherence was measured by medication possession ratio (MPR) and appropriate-adherence was defined as MPR 0.8-1.1. Persistence was measured by 12-month cumulative persistence rate. Logistic regression and Cox proportional hazard model were used to estimate the impact of CMPD on the appropriateness of medication adherence and persistence. The odds of achieving appropriate-adherence was 2.05 times higher and the risk of discontinuation of medication was 0.89 times lower among shifters to clinic in hypertension group compared to non-shifters to clinic. No significant difference was verified among dyslipidemia group. CDMP was effective to improve medication adherence and persistence by significantly increasing probability to achieve appropriate-adherence and decreasing discontinuation risk of medication in patients with hypertension in Korea. Given these findings, our study suggests that CDMP should be further applied to other major chronic diseases not being limited to hypertension and diabetes.
|
|
|
KEYWORD
|
|
|
Chronic Disease Management Program, Hypertension, Diabetes, Medication Adherence, Persistence
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|