Medication adherence prevents hospitalization among hypertensive, diabetic older adults

Older adults with diabetes and hypertension who regularly take their medications tend to have fewer hospitalizations or visits to the emergency room (ER), reports a study.

Individuals aged 75‒90 years, diagnosed with diabetes or hypertension, who received at least one antihypertensive or antidiabetic medication in 2017 were enrolled in this study.

The researchers measured the personal adherence rates by calculating the mean adherence rates of the medications prescribed to each participant. They also obtained data on ER visits and hospitalizations in internal medicine and surgical wards from 2017 to 2019 and on mortality in 2019.

A total of 171,097 individuals (mean age 81.2 years, 60 percent women) were analysed, of whom 93 percent were hypertensive, 46 percent diabetic, and 39 percent both hypertensive and diabetic.

A total of 61,668 (36.0 percent) patients visited the ER and 44,910 (26.2 percent) were hospitalized in internal medicine wards and 13,305 (7.8 percent) in surgical wards in 2017.

Older patients with the highest adherence to medications were less likely to visit the ER (odds ratio [OR], 0.69, 95 percent confidence interval [CI], 0.63‒0.76) and to be hospitalized in internal medicine wards (OR, 0.40, 95 percent CI, 0.36‒0.45) or in surgery wards (OR, 0.61, 95 percent CI, 0.52‒0.72) than those with the lowest adherence.

ORs were comparable for the years 2017, 2018, and 2019. In 2019, the incidence of all-cause mortality remains lower for patients in the highest adherence quintile (OR, 0.60, 95 percent CI, 0.54‒0.66) relative to those in the lowest quintile.

“Better medication adherence was associated with fewer ER visits and hospitalizations among [older] patients with diabetes and hypertension and lower mortality rates,” the researchers said.

“Overall medication adherence is an indicator for health outcomes unrelated to the patient's underlying health status,” they added.