Representativeness of the "Fiesole Misurata" study database for use in pharmaco-epidemiological investigations on adherence to antihypertensive medications

Poor adherence to medications is a major health concern especially among older subjects. To plan future studies to improve adherence, an epidemiological study, called "Fiesole Misurata", was conducted. The aim of the present paper was to verify the representativeness of the database in evaluating the AntiHyperTensives (AHTs)-taking behaviour.Demographic records of all subjects aged ≥65 years (n = 2,228) living in the community of Fiesole (Florence, Italy) was retrieved from the Registry Office of Fiesole Municipality. The corresponding healthcare records were obtained from administrative archives of the Local Health Authority (claim dataset). Moreover, a cohort of subjects aged ≥65 years (n = 385) living in the community was screened by means of a multidimensional geriatric evaluation (cross-sectional dataset).In claim dataset, biyearly prevalences of hospitalization for ischemic cardiomyopathy, heart failure, and stroke were 3.7, 3.0, and 3.2\%, respectively. In the cross-sectional dataset, prevalences were 11.2, 6.7, and 7.1\%, respectively. The most used drugs were angiotensin-converting enzyme inhibitors (43.6\% in the claim dataset, 45.3\% in the cross-sectional dataset) and diuretics (35.6\% and 47.0\%, respectively). Among the incident users of AHTs, 63.5\% was highly adherent (≥80\%) over the first 6 months of follow-up, while 14.3 and 22.2\% were intermediate (40-79\%) and low (<40\%) adherent. The percentage of high adherers decreased with time and reached 31.2\% at the 24th month.These findings indicate that "Fiesole Misurata" study database can be used to develop future strategies aimed at improving the adherence to AHTs in older individuals.