Abstract
The chronic disease management program, a community-based intervention including patient education, recall and remind service, and reduction of out-of-pocket payment, was implemented in 2005 in Korea to improve patients’ adherence for antihypertensive medications. This study aimed to assess the effect of a community-based hypertension intervention intended to enhance patient adherence to prescribed medications. This study applied a non-equivalent control group design using the Korean National Health Insurance Big Data. Hongcheon County has been continuously implementing the intervention program since 2012. This study involved a cohort of patients with hypertension aged >65 and <85 years, among residents who lived in the study area for five years (between 2010 and 2014). The final number of subjects was 2685 in both the intervention and control region. The indirect indicators were analyzed as patients’ adherence and level of continuous treatment using the difference-in-difference regression. The proportion of hypertensive patients who continuously received insurance benefits for >240 days in 2014 was 81.0% in the intervention region and 79.7% in the control region. The number of dispensations per prescription and the dispensation days per hypertensive patient in the intervention region increased by approximately 10.88% and 2.2 days on average by month, respectively, compared to those in the control region. The intervention program encouraged elderly patients with hypertension to receive continuous care. Another research is needed to determine whether further improvement in the continuity of comprehensive care will prevent the progression of cardiovascular diseases.
Highlights
The United Nations (UN) reached an agreement titled “Political Declaration of the High-LevelMeeting of the General Assembly on the Prevention and Control of Non-Communicable Diseases (NCDs)” in 2011 to respond to the crisis of double burden of NCDs [1]
This study used a non-equivalent control group design that assessed patients with hypertension in the regions regarding whether the community-based intervention was implemented or not
The community-based intervention for managing hypertension had been implemented for 6 years is Hongcheon County
Summary
The United Nations (UN) reached an agreement titled “Political Declaration of the High-Level. Meeting of the General Assembly on the Prevention and Control of Non-Communicable Diseases (NCDs)” in 2011 to respond to the crisis of double burden of NCDs [1]. According to various studies such as the Global Burden of Disease (GBD) Study 2010, GBD Study 2013, and GBD Study 2015 [2,3,4,5], NCDs account for more than one-half of the global burden of disease. Cardiovascular diseases (CVD) account for about one-half of NCD deaths. In addition to health-related behaviors like tobacco. Res. Public Health 2019, 16, 721; doi:10.3390/ijerph16050721 www.mdpi.com/journal/ijerph
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