Comparison of Different Strategies to Measure Medication Adherence via Claims Data in Patients With Chronic Heart Failure

Clin Pharmacol Ther. 2019 Jul;106(1):211-218. doi: 10.1002/cpt.1378. Epub 2019 Mar 12.


Medication adherence correlates with morbidity and mortality in patients with chronic heart failure (CHF), but is difficult to assess. We conducted a retrospective methodological cohort study in 3,808 CHF patients, calculating adherence as proportion of days covered (PDC) utilizing claims data from 2010 to 2015. We aimed to compare different parameters' influence on the PDC of elderly CHF patients exemplifying a complex chronic disease. Investigated parameters were the assumed prescribed daily dose (PDD), stockpiling, and periods of hospital stay. Thereby, we investigated a new approach using the PDD assigned to different percentiles. The different dose assumptions had the biggest influence on the PDC, with variations from 41.9% to 83.7%. Stockpiling and hospital stays increased the values slightly. These results queries that a reliable PDC can be calculated with an assumed PDD. Hence, results based on an assumed PDD have to be interpreted carefully and should be presented with sensitivity analyses to show the PDC's possible range.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cardiovascular Agents / administration & dosage
  • Cardiovascular Agents / therapeutic use*
  • Dose-Response Relationship, Drug
  • Female
  • Heart Failure / drug therapy*
  • Humans
  • Insurance Claim Review / statistics & numerical data*
  • Length of Stay
  • Male
  • Medication Adherence / statistics & numerical data*
  • Research Design
  • Retrospective Studies
  • Severity of Illness Index


  • Cardiovascular Agents