Michal Shani, MD, MPH; Yochai Schonmann, MD, MSc; Doron Comaneshter, PhD; Alex Lustman, MbCHB, MPH
Corresponding Author: Michal Shani, MD, MPH; Department of Family Medicine Sackler Faculty of Medicine - Tel Aviv University. Email: michal.shani@gmail.com
Section: Original Research
Publication: 11/11/2021
Background: To study the relation between adherence to chronic medications and adherence to preventive medicine recommendations among persons with diabetes mellitus and hypertension. Methods: Data was collected from the Clalit database. Included were all members of "Clalit" aged 50-74 years, with a diagnosis of diabetes mellitus or hypertension before 2016, who were treated with at least one medication (statins hypotensive or anti-diabetic 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 screen, and mammography. Results: Of 268,792 persons, 81.1% had hypertension and 59.5% had diabetes; 40.6% had both diabetes and hypertension. The mean age was 63.7 years. 50.6% were men. The mean number of medications used was 2.2±1.1. An adherence rate of ≤20% was found in 4.2%, and >80% in 42.5%. 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.