Rising Trends in Medication Non-compliance and Associated Worsening Cardiovascular and Cerebrovascular Outcomes Among Hospitalized Adults Across the United States
Introduction Small-scale studies have described concerning rates of non-compliance/nonadherence towards groups of medications for primary and secondary prevention. Trends in cardiovascular and cerebrovascular events (CCE) among hospitalized patients with a non-compliant behavior towards medication, on the whole, remains unexplored on a large scale. Methods Using the National Inpatient Sample databases (2007-2014), we sought to assess the prevalence and trends in all-cause mortality and CCE in adult patients hospitalized with medication non-compliance. We compared baseline characteristics and comorbidities in the non-compliant patients with and without concomitant in-hospital CCE. Results We identified 7,453,831 adult hospitalizations with medication non-compliance from 2007 to 2014, of which 867,997 (11.6%) patients demonstrated in-hospital CCE. Non-compliant patients with CCE consisted of a higher number of older, white, male patients having greater comorbid risk factors. Non-compliant patients with CCE had higher all-cause in-hospital mortality (3% vs. 0.7%), frequent transfers [4.4% vs. 1.8% transfers to short-term hospitals, and 17.6% vs. 11.6% other transfers (skilled nursing or intermediate care facilities)], lower routine discharges (59.4% vs. 71.1%), and higher mean hospital charges ($52,740 vs. $30,748) compared to non-compliant patients without CCE. Remarkably, this study demonstrates the rising trend in medication non-compliance across all age, sex, and race groups, and related in-hospital mortality, CCE, transfers to other facilities, and the health care cost from 2007 to 2014. Conclusions We observed rising trends in the prevalence of medication non-compliance and subsequent in-hospital mortality in hospitalizations among adults from 2007 to 2014. Non-compliant patients with inpatient CCE demonstrated rising trends in all-cause mortality, complications, health care utilization, and cost from 2007 to 2014.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:11 |
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| Enthalten in: |
Cureus - 11(2019), 8 vom: 14. Aug., Seite e5389 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Desai, Rupak [VerfasserIn] |
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| Links: |
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| Themen: |
Arrhythmias |
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| Anmerkungen: |
Date Revised 01.10.2020 published: Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.7759/cureus.5389 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM300911750 |
|---|
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| 100 | 1 | |a Desai, Rupak |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Rising Trends in Medication Non-compliance and Associated Worsening Cardiovascular and Cerebrovascular Outcomes Among Hospitalized Adults Across the United States |
| 264 | 1 | |c 2019 | |
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| 520 | |a Introduction Small-scale studies have described concerning rates of non-compliance/nonadherence towards groups of medications for primary and secondary prevention. Trends in cardiovascular and cerebrovascular events (CCE) among hospitalized patients with a non-compliant behavior towards medication, on the whole, remains unexplored on a large scale. Methods Using the National Inpatient Sample databases (2007-2014), we sought to assess the prevalence and trends in all-cause mortality and CCE in adult patients hospitalized with medication non-compliance. We compared baseline characteristics and comorbidities in the non-compliant patients with and without concomitant in-hospital CCE. Results We identified 7,453,831 adult hospitalizations with medication non-compliance from 2007 to 2014, of which 867,997 (11.6%) patients demonstrated in-hospital CCE. Non-compliant patients with CCE consisted of a higher number of older, white, male patients having greater comorbid risk factors. Non-compliant patients with CCE had higher all-cause in-hospital mortality (3% vs. 0.7%), frequent transfers [4.4% vs. 1.8% transfers to short-term hospitals, and 17.6% vs. 11.6% other transfers (skilled nursing or intermediate care facilities)], lower routine discharges (59.4% vs. 71.1%), and higher mean hospital charges ($52,740 vs. $30,748) compared to non-compliant patients without CCE. Remarkably, this study demonstrates the rising trend in medication non-compliance across all age, sex, and race groups, and related in-hospital mortality, CCE, transfers to other facilities, and the health care cost from 2007 to 2014. Conclusions We observed rising trends in the prevalence of medication non-compliance and subsequent in-hospital mortality in hospitalizations among adults from 2007 to 2014. Non-compliant patients with inpatient CCE demonstrated rising trends in all-cause mortality, complications, health care utilization, and cost from 2007 to 2014 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a arrhythmias | |
| 650 | 4 | |a cardiovascular diseases | |
| 650 | 4 | |a cerebrovascular disease | |
| 650 | 4 | |a medication non-compliance | |
| 650 | 4 | |a mortality | |
| 650 | 4 | |a myocardial infarction | |
| 650 | 4 | |a non adherence | |
| 650 | 4 | |a stroke | |
| 650 | 4 | |a trends | |
| 650 | 4 | |a venous thromboembolism | |
| 700 | 1 | |a Thakkar, Samarthkumar |e verfasserin |4 aut | |
| 700 | 1 | |a Fong, Hee Kong |e verfasserin |4 aut | |
| 700 | 1 | |a Varma, Yash |e verfasserin |4 aut | |
| 700 | 1 | |a Ali Khan, Mir Z |e verfasserin |4 aut | |
| 700 | 1 | |a Itare, Vikram B |e verfasserin |4 aut | |
| 700 | 1 | |a Raina, Jilmil S |e verfasserin |4 aut | |
| 700 | 1 | |a Savani, Sejal |e verfasserin |4 aut | |
| 700 | 1 | |a Damarlapally, Nanush |e verfasserin |4 aut | |
| 700 | 1 | |a Doshi, Rajkumar P |e verfasserin |4 aut | |
| 700 | 1 | |a Gangani, Kishorbhai |e verfasserin |4 aut | |
| 700 | 1 | |a Sitammagari, Kranthi |e verfasserin |4 aut | |
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