scholarly journals The Association Between Medication Adherence for Chronic Conditions and Digital Health Activity Tracking: Retrospective Analysis

10.2196/11486 ◽  
2019 ◽  
Vol 21 (3) ◽  
pp. e11486 ◽  
Author(s):  
Tom Quisel ◽  
Luca Foschini ◽  
Susan M Zbikowski ◽  
Jessie L Juusola
Keyword(s):  
Health Care ◽  
Medication Adherence ◽  
Health Outcomes ◽  
Fixed Effects ◽  
Digital Health ◽  
Positive Association ◽  
Activity Tracking ◽  
Pharmacy Claims ◽  
The Relationship ◽  
Age And Sex

Background Chronic diseases have a widespread impact on health outcomes and costs in the United States. Heart disease and diabetes are among the biggest cost burdens on the health care system. Adherence to medication is associated with better health outcomes and lower total health care costs for individuals with these conditions, but the relationship between medication adherence and health activity behavior has not been explored extensively. Objective The aim of this study was to examine the relationship between medication adherence and health behaviors among a large population of insured individuals with hypertension, diabetes, and dyslipidemia. Methods We conducted a retrospective analysis of health status, behaviors, and medication adherence from medical and pharmacy claims and health behavior data. Adherence was measured in terms of proportion of days covered (PDC), calculated from pharmacy claims using both a fixed and variable denominator methodology. Individuals were considered adherent if their PDC was at least 0.80. We used step counts, sleep, weight, and food log data that were transmitted through devices that individuals linked. We computed metrics on the frequency of tracking and the extent to which individuals engaged in each tracking activity. Finally, we used logistic regression to model the relationship between adherent status and the activity-tracking metrics, including age and sex as fixed effects. Results We identified 117,765 cases with diabetes, 317,340 with dyslipidemia, and 673,428 with hypertension between January 1, 2015 and June 1, 2016 in available data sources. Average fixed and variable PDC for all individuals ranged from 0.673 to 0.917 for diabetes, 0.756 to 0.921 for dyslipidemia, and 0.756 to 0.929 for hypertension. A subgroup of 8553 cases also had health behavior data (eg, activity-tracker data). On the basis of these data, individuals who tracked steps, sleep, weight, or diet were significantly more likely to be adherent to medication than those who did not track any activities in both the fixed methodology (odds ratio, OR 1.33, 95% CI 1.29-1.36) and variable methodology (OR 1.37, 95% CI 1.32-1.43), with age and sex as fixed effects. Furthermore, there was a positive association between frequency of activity tracking and medication adherence. In the logistic regression model, increasing the adjusted tracking ratio by 0.5 increased the fixed adherent status OR by a factor of 1.11 (95% CI 1.06-1.16). Finally, we found a positive association between number of steps and adherent status when controlling for age and sex. Conclusions Adopters of digital health activity trackers tend to be more adherent to hypertension, diabetes, and dyslipidemia medications, and adherence increases with tracking frequency. This suggests that there may be value in examining new ways to further promote medication adherence through programs that incentivize health tracking and leveraging insights derived from connected devices to improve health outcomes.

scholarly journals The Association Between Medication Adherence for Chronic Conditions and Digital Health Activity Tracking: Retrospective Analysis (Preprint)

2018 ◽  
Author(s):  
Tom Quisel ◽  
Luca Foschini ◽  
Susan M Zbikowski ◽  
Jessie L Juusola
Keyword(s):  
Health Care ◽  
Medication Adherence ◽  
Health Outcomes ◽  
Fixed Effects ◽  
Digital Health ◽  
Positive Association ◽  
Activity Tracking ◽  
Pharmacy Claims ◽  
The Relationship ◽  
Age And Sex

BACKGROUND Chronic diseases have a widespread impact on health outcomes and costs in the United States. Heart disease and diabetes are among the biggest cost burdens on the health care system. Adherence to medication is associated with better health outcomes and lower total health care costs for individuals with these conditions, but the relationship between medication adherence and health activity behavior has not been explored extensively. OBJECTIVE The aim of this study was to examine the relationship between medication adherence and health behaviors among a large population of insured individuals with hypertension, diabetes, and dyslipidemia. METHODS We conducted a retrospective analysis of health status, behaviors, and medication adherence from medical and pharmacy claims and health behavior data. Adherence was measured in terms of proportion of days covered (PDC), calculated from pharmacy claims using both a fixed and variable denominator methodology. Individuals were considered adherent if their PDC was at least 0.80. We used step counts, sleep, weight, and food log data that were transmitted through devices that individuals linked. We computed metrics on the frequency of tracking and the extent to which individuals engaged in each tracking activity. Finally, we used logistic regression to model the relationship between adherent status and the activity-tracking metrics, including age and sex as fixed effects. RESULTS We identified 117,765 cases with diabetes, 317,340 with dyslipidemia, and 673,428 with hypertension between January 1, 2015 and June 1, 2016 in available data sources. Average fixed and variable PDC for all individuals ranged from 0.673 to 0.917 for diabetes, 0.756 to 0.921 for dyslipidemia, and 0.756 to 0.929 for hypertension. A subgroup of 8553 cases also had health behavior data (eg, activity-tracker data). On the basis of these data, individuals who tracked steps, sleep, weight, or diet were significantly more likely to be adherent to medication than those who did not track any activities in both the fixed methodology (odds ratio, OR 1.33, 95% CI 1.29-1.36) and variable methodology (OR 1.37, 95% CI 1.32-1.43), with age and sex as fixed effects. Furthermore, there was a positive association between frequency of activity tracking and medication adherence. In the logistic regression model, increasing the adjusted tracking ratio by 0.5 increased the fixed adherent status OR by a factor of 1.11 (95% CI 1.06-1.16). Finally, we found a positive association between number of steps and adherent status when controlling for age and sex. CONCLUSIONS Adopters of digital health activity trackers tend to be more adherent to hypertension, diabetes, and dyslipidemia medications, and adherence increases with tracking frequency. This suggests that there may be value in examining new ways to further promote medication adherence through programs that incentivize health tracking and leveraging insights derived from connected devices to improve health outcomes.

Abstract P50: Early Nonadherence to Antihypertensive Medications

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Emily B Schroeder ◽  
Jennifer L Ellis ◽  
Nikki M Carroll ◽  
Elizabeth A Bayliss ◽  
Marsha A Raebel
Keyword(s):  
Health Care ◽  
Medication Adherence ◽  
Antihypertensive Medication ◽  
Multivariate Model ◽  
Care Plan ◽  
Office Visits ◽  
Antihypertensive Medications ◽  
Kaiser Permanente ◽  
Pharmacy Claims ◽  
C Statistic

Background: Medication adherence is extremely important in the treatment of hypertension. Most medication adherence metrics are based on refill rates from pharmacy claims databases and require at least two drug dispensings for the calculations. Little is known about individuals who demonstrate early non-adherence to antihypertensive medications, either by never filling a prescription (primary non-adherence) or by filling a prescription only once (early non-persistence). Methods: We conducted a retrospective cohort study of 6,393 Kaiser Permanente Colorado enrollees with hypertension who received a first prescription for an antihypertensive medication between January 1, 2007 and June 30, 2008. We linked prescription orders to medication dispensings and then classified patients into primary non-adherent, early non-persistent, or ongoing dispensings groups. Multivariate logistic modeling was performed to investigate potential predictors of primary non-adherence compared to ongoing dispensings. Results: Five percent (331 of 6,393) of patients were primarily non-adherent, 26% (1,672 of 6,393) demonstrated early non-persistence, and 69% (4,390 of 6,393) received ongoing dispensings. In a multivariate model, the following characteristics were associated with a higher likelihood of exhibiting primary non-adherence compared to receiving ongoing dispensings: Hispanic (OR 1.74, 95% CI 1.20-2.52) or other racial/ethnic minority (1.48, 1.13-1.95), an enrollment period less than 10 years (1.28,1.00-1.62), more than four comorbidities compared to no comorbidities (1.76, 1.02-3.02), and fewer than five health care contacts in the six months after the medication was prescribed (1.31, 1.02-1.67). The copayment amount for office visits or medications was not associated with primary non-adherence. The c-statistic for the model containing demographic characteristics, comorbidities, and health care plan information was 0.63. Conclusions: A substantial number of individuals newly prescribed an antihypertensive medication exhibited early non-adherence. Our multivariate model had limited discrimination, indicating that further research is needed to better characterize these individuals and explore barriers to early adherence.

Globalization and women’s and girls’ health in 192 UN-member countries

2016 ◽  
Vol 43 (7) ◽  
pp. 692-721 ◽  
Author(s):  
Deniz Gevrek ◽  
Karen Middleton
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Life Expectancy ◽  
Health Outcomes ◽  
Fixed Effects ◽  
Content Type ◽  
Life Expectancy At Birth ◽  
Adolescent Fertility ◽  
The Impact ◽  
The Relationship

Purpose – The purpose of this paper is to explore the relationship between the ratification of the United Nations’ (UN’s) Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) and women’s and girls’ health outcomes using a unique longitudinal data set of 192 UN-member countries that encompasses the years from 1980 to 2011. Design/methodology/approach – The authors focus on the impact of CEDAW ratification, number of reports submitted after ratification, years passed since ratification, and the dynamic impact of CEDAW ratification by utilizing ordinary least squares (OLS) and panel fixed effects methods. The study investigates the following women’s and girls’ health outcomes: total fertility rate, adolescent fertility rate, infant mortality rate, maternal mortality ratio, neonatal mortality rate, female life expectancy at birth (FLEB), and female to male life expectancy at birth. Findings – The OLS and panel country and year fixed effects models provide evidence that the impact of CEDAW ratification on women’s and girls’ health outcomes varies by global regions. While the authors find no significant gains in health outcomes in European and North-American countries, the countries in the Northern Africa, sub-Saharan Africa, Southern Africa, Caribbean and Central America, South America, Middle-East, Eastern Asia, and Oceania regions experienced the biggest gains from CEDAW ratification, exhibiting reductions in total fertility, adolescent fertility, infant mortality, maternal mortality, and neonatal mortality while also showing improvements in FLEB. The results provide evidence that both early commitment to CEDAW as measured by the total number of years of engagement after the UN’s 1980 ratification and the timely submission of mandatory CEDAW reports have positive impacts on women’ and girls’ health outcomes. Several sensitivity tests confirm the robustness of main findings. Originality/value – This study is the first comprehensive attempt to explore the multifaceted relationships between CEDAW ratification and female health outcomes. The study significantly expands on the methods of earlier research and presents novel methods and findings on the relationship between CEDAW ratification and women’s health outcomes. The findings suggest that the impact of CEDAW ratification significantly depends on the country’s region. Furthermore, stronger engagement with CEDAW (as indicated by the total number of years following country ratification) and the submission of the required CEDAW reports (as outlined in the Convention’s guidelines) have positive impacts on women’s and girls’ health outcomes.

Engaging Patients and Lowering Costs

2017 ◽  
pp. 115-138
Author(s):  
Tony Zordich ◽  
Julia Menichetti
Keyword(s):  
Health Care ◽  
Medication Adherence ◽  
Health Literacy ◽  
Health Outcomes ◽  
Patient Care ◽  
Economic Impact ◽  
Behavior Modification ◽  
Hospital Readmission ◽  
Care Process ◽  
Technological Tools

Societies need solutions to achieve the “triple aim” of improved health outcomes, better patient care, and lower costs; and engaging patients in their care by using technological solutions is claimed as a possible strategy to achieve this vital goal. On this basis, the chapter focuses on reviewing, categorizing and synthesizing technological tools currently available in the market today designed to engage patients in their own care process. In particular, the goals of medication adherence, reduced hospital readmission, behavior modification, and health literacy - with related technologies - are assessed, since they are considered todays most expensive health care burdens. The advantages, shortcomings, and potential economic impact of such tools are finally discussed.

scholarly journals Housing and Health among Young First Nations Children Living Off Reserve: Results from the 2006 Aboriginal Children’s Survey

2016 ◽  
Vol 5 (2) ◽  
Author(s):  
Anne Guevremont ◽  
Evelyne Bougie ◽  
Dafna Kohen
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
First Nations ◽  
Regression Models ◽  
Parental Satisfaction ◽  
Future Research ◽  
Housing Conditions ◽  
Physical And Mental Health ◽  
The Relationship ◽  
Age And Sex

First Nations children in Canada often experience poorer housing conditions than other Canadian children. This study used the 2006 Aboriginal Children’s Survey to examine the relationship between housing and physical and mental health for First Nations preschool-aged children living off-reserve. This study provides evidence that the physical, spatial, and psychological aspects of housing in which young off-reserve First Nations children live are associated with their physical and mental health, even after controlling for family socioeconomic factors, area of residence, and child’s age and sex (analyzed with regression models). In particular, homeownership, parental satisfaction with housing, and number of moves per year were all associated with multiple physical and mental health outcomes. Future research is needed to further investigate the mechanisms at play.

scholarly journals Self-reported work activities, mucus membrane symptoms, and respiratory health outcomes among an industrial hog operation worker cohort, North Carolina, USA

2020 ◽  
Author(s):  
Vanessa Renee Coffman ◽  
Devon J Hall ◽  
Nora Pisanic ◽  
David C Love ◽  
Maya Nadimpalli ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Fixed Effects ◽  
Respiratory Health ◽  
Specific Work ◽  
Health Symptoms ◽  
Work Activities ◽  
Logistic Regression Models ◽  
Adverse Health Outcomes ◽  
Mucus Membrane ◽  
The Relationship

Background: Respiratory disease among industrial hog operation (IHO) workers is well documented; however, it remains unclear whether specific work activities are more harmful and if personal protective equipment (PPE), as used by workers, can reduce adverse health outcomes. Objectives: To assess the relationship between self-reported IHO work activities and PPE use with mucus membrane and respiratory health symptoms in an occupational cohort. Methods: IHO workers (n=103) completed baseline and up to eight bi-weekly (i.e., every two weeks) study visits. Workers reported typical (baseline) and transient (bi-weekly) work activities, PPE use, and physical health symptoms. Baseline and longitudinal associations between work activities and health outcomes were assessed using generalized logistic and fixed-effects logistic regression models, respectively. Results: At baseline, reports of ever versus never drawing pig blood, applying pesticides, and increasing years worked at any IHO were positively associated with reports of eye, nose, and/or throat irritation. Over time, transient exposures, including those associated with dustiness in barns, cleaning of barns, and pig contact were associated with increased odds of symptoms including sneezing, headache, and eye or nose irritation, particularly in the highest categories of exposure. When PPE was used, workers had decreased odds of symptoms interfering with sleep (odds ratio (OR): 0.1; 95% confidence interval (CI): 0.01, 0.8), sneezing (OR: 0.1; 95% CI: 0.01, 1.0), and eye or nose irritation (OR: 0.1; 95% CI: 0.02, 0.9). Similarly, when they washed their hands ≥8 times per shift (the median) versus less frequently, workers had decreased odds of any respiratory symptom (OR: 0.3; 95% CI: 0.1, 0.8). Discussion: In this healthy volunteer IHO worker population, increasingly unfavorable work activities were associated with self-reported mucus membrane and respiratory health outcomes. Strong protective associations were seen between PPE use and handwashing and the odds of symptoms, warranting further investigation in intervention studies.

scholarly journals Accounting Treatment of R&D for Environmentally Responsible Firms: Evidence from South Korea

2020 ◽  
Vol 12 (8) ◽  
pp. 3418
Author(s):  
Suyon Kim ◽  
Jaehong Lee
Keyword(s):  
Environmental Performance ◽  
Fixed Effects ◽  
Stock Exchange ◽  
Positive Association ◽  
Environmental Responsibility ◽  
Alternative Measure ◽  
Corporate Environmental Responsibility ◽  
Commercial Success ◽  
Environmentally Responsible ◽  
The Relationship

The purpose of this paper is to investigate the relationship between corporate environmental responsibility (CER) and R&D accounting treatment. Using firms listed in the Korea Stock Exchange (KSE) market between the years 2014 and 2018, this study not only investigates this relationship but also expands upon CER activities in various aspects, such as environmental performance strategy, environmental performance organization, and environmental shareholders. Furthermore, the positive association between various CER activities and R&D capitalization is significant in a highly competitive market. This relationship is robust with an alternative measure of CER activities and firm-fixed effects. This result implies that firms participating in CER activities focus on sustainable commercial success, unlike other firms.

Engaging Patients and Lowering Costs

2017 ◽  
pp. 920-937
Author(s):  
Tony Zordich ◽  
Julia Menichetti
Keyword(s):  
Health Care ◽  
Medication Adherence ◽  
Health Literacy ◽  
Health Outcomes ◽  
Patient Care ◽  
Economic Impact ◽  
Behavior Modification ◽  
Hospital Readmission ◽  
Care Process ◽  
Technological Tools

Societies need solutions to achieve the “triple aim” of improved health outcomes, better patient care, and lower costs; and engaging patients in their care by using technological solutions is claimed as a possible strategy to achieve this vital goal. On this basis, the chapter focuses on reviewing, categorizing and synthesizing technological tools currently available in the market today designed to engage patients in their own care process. In particular, the goals of medication adherence, reduced hospital readmission, behavior modification, and health literacy - with related technologies - are assessed, since they are considered todays most expensive health care burdens. The advantages, shortcomings, and potential economic impact of such tools are finally discussed.

Sign in / Sign up

Export Citation Format

Share Document