מילות מפתח: continuity of care in primary care - medication adherence

רקע מדעי ומטרה:

Poor medication adherence in chronic diseases worsens outcomes and increases healthcare costs. Continuity of care (COC) may improve adherence, yet existing evidence is inconsistent, particularly for dyslipidemia, chronic obstructive pulmonary disease (COPD), and depression in primary care.
This retrospective cohort study examines whether higher continuity—measured by the Usual Provider Continuity (UPC) and Continuity of Care Index (COCI)—predicts better medication adherence, measured by Medication Possession Ratio (MPR) and Proportion of Days Covered (PDC), among patients newly diagnosed with dyslipidemia, COPD, or depression in the Clalit health system from January 2022 to December 2024

שיטות:

We will include adult Clalit members with a confirmed new diagnosis in 2022, ≥4 primary care visits during the first 18‑month continuity period, and no prior history of the target condition or major related events. For each patient, UPC and COCI will be calculated over 18 months; adherence (MPR, PDC) will be assessed over the subsequent 6‑month outcome period. Covariates include age, sex, Charlson comorbidity index, socioeconomic status, clinic type and sector, visit modality (including telemedicine), and hospitalizations

תוצאות:

We hypothesize that higher continuity will be significantly associated with increased medication adherence across all three conditions, with a stronger effect in multimorbid patients. Specific patterns of continuity are expected to yield the greatest benefit

מסקנות:

Findings will inform community-based interventions to enhance continuity of care, improve medication adherence, and optimize outcomes in chronic disease management.

חשיבות לרפואת המשפחה:

it highlights how strong, continuous relationships between patients and their primary care providers can significantly improve medication adherence in chronic conditions.