Socio-demographic and genetic risk factors for drug adherence and persistence: a retrospective nation-wide and biobank study across 5 medication classes and 1 814 521 individuals

Abstract

AbstractLow drug adherence is a major obstacle to the benefits of pharmacotherapies, and it is therefore important to identify factors associated with discontinuing or being poorly adherent to a prescribed treatment regimen. Using high-quality nationwide health registry data and genome-wide genotyping, we evaluate the impact of socio-demographic and genetic risk factors on adherence and persistence for 5 common medication classes that require long-term, regular therapy (N = 1 814 591 individuals, 185 931 with genetic data).Need for social assistance and immigration status showed a notable negative effect on persistence and adherence across the examined medications (odd ratios between 0.48 and 0.82 for persistence and between 1.1% to 4.3% decrease in adherence) while demographic (age and sex), health (comorbidity status), and genetic factors showed comparably modest or inconsistent effects. Some pharmacogenes were modestly associated with persistence, but not with adherence. We observed significant genetic correlations between medication adherence and participation in research studies. Overall, our findings suggest that socio-economically disadvantaged groups would benefit from targeted interventions to improve the dispensing and uptake of pharmacological treatments.