Drug therapy adherence and health outcomes in the presence of physician and patient unobserved heterogeneity

Health Econ. 2017 Sep:26 Suppl 2:106-126. doi: 10.1002/hec.3570.

Abstract

Understanding the role that drug adherence has on health outcomes in everyday clinical practice is central for the policy maker. This is particularly true when patients suffer from asymptomatic chronic conditions (e.g., hypertension, hypercholesterolaemia, and diabetes). By exploiting a unique longitudinal dataset at patient and physician level in Italy, we show that patients and physicians unobserved characteristics play an important role in determining health status, at least as important as drug adherence. Most importantly, we find that both adherence and prescribed treatment regimen effects are highly heterogeneous across physicians, highlighting their crucial role in shaping patients' health status.

Keywords: drug adherence; health outcomes; patient heterogeneity; physician heterogeneity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anticholesteremic Agents / therapeutic use
  • Comorbidity
  • Female
  • Health Status*
  • Humans
  • Hypercholesterolemia / drug therapy
  • Italy
  • Longitudinal Studies
  • Male
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Models, Econometric
  • Patient Dropouts / statistics & numerical data
  • Physician's Role*
  • Physician-Patient Relations
  • Physicians / statistics & numerical data*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Residence Characteristics / statistics & numerical data

Substances

  • Anticholesteremic Agents