Analysis on the effect of consultation program to improve medication adherence

Abstract

Hypertension and diabetes are the very common chronic diseases with each prevalence of nearly 30% and 10% among South Korean aged over 30 and this is increased along with aging. These diseases are well-known risk factors for severe diseases including cardiovascular disease (CVD) which is a leading cause of death globally, so they needed to manage continually. The purpose of this study is to evaluate the effect of consultation program on medication adherence in hypertension and diabetes patients. In an effort to improve hypertension and diabetes care, National Health Insurance Service (NHIS) has implemented a consultation program from July 2013 for 3 months. This study examined the effect of this program between before and after conducting intervention using eligibility, medical treatment and health examination data from NHIS. To evaluate the actual effect of the intervention, this study select controls which have similar characteristics with participants using propensity score matching (PSM), and then the change of medication possession ratio were analyzed with Difference-in-Differences (DID) method, comparing with participants and controls. As results of this study, the effect of consultation program on MPR was confirmed with statistical significance in hypertension and diabetes participants and all types of MPR group. As for IG-MU, the MPR was 2.27% increased after intervention in hypertension participants (p=0.0153) and 7.26% increase in diabetes participants (p=0.0020). As for IG-MO, the MPR was 8.04% decreased after intervention in hypertension participants (p=0.0013) and 9.73% decreased in diabetes participants (p=0.0122). And the effect of intervention by state of newly diagnosed patients was also found in hypertension participants. Through this study results, the effect of consultation program change subjects medication adherence in an appropriate way. Especially, this study shows that the consultation program is more effective in patients who are newly diagnosed as hypertension than pre-existing hypertension patients. This study provides scientific and documented evidences regarding extended enforcement of personalized consultation program to improve medication adherence. And this study suggests that it needs to implement consultation program which is effective and active management service about chronic disease on the national scale.