Researchers: Walid Saliba ¹, Naomi Gronich ¹

Background: Noncompliance to treatment is a widespread phenomenon. There is insufficient information on the level of compliance to drug treatment and its implications on the health of the Israeli population.

Objectives: To estimate the extent of noncompliance to medications, to identify risk factors and to examine implications of noncompliance on health of Israeli patients with selected cardiovascular diseases.

Method: The study is based on data from the database of Clalit Health Services, and focuses on testing the compliance to selected medications (statins, beta-blockers and ACE-inh/ARBs) among patients discharged with primary diagnosis of myocardial infarction and heart failure between January 2005 and December 2014. Compliance with treatments was estimated using the proportion of days covered (PDC) measure.

Findings: High level of compliance with medications, defined as PDC ≥80%, was detected 50% to 64% of cases, depending on the drugs tested. We observed a trend of gradual increase, albeit slow, in the level of compliance with medications, and the gap between the levels of compliance between the study drugs has narrowed in recent years. High socioeconomic status, belonging to the Jewish sector, older age, and compliance with screening tests were all associated with increased medication compliance. Male sex, ever smoking and COPD were independently associated with decreased compliance to medications. In general, increased compliance to the most of the tested drugs was significantly associated with favorable outcome both in patients with myocardial infarction and heart failure.

Conclusions: Our study shows that compliance to the examined medications is still not optimal. Certain subpopulations were found to have consistently low compliance to medications and need targeted intervention.

Recommendations: Efforts should be done to increase adherence to medications, especially in low socioeconomic class patients, Arabs, males, younger patients, non-compliers with screening tests, smokers and COPD patients.

Research end date: 08/2020