Short summary

The prevalence of chronic diseases and multimorbidity is increasing, causing significant challenges for healthcare systems. Long-term medical treatment is often necessary, and the patient's adherence to the prescribed treatment regimen plays a crucial role in determining their prognosis. This project aims is to investigate the prevalence and consequences of chronic diseases and multimorbidity among Danish adults, and to relate this to the extent and impact of low adherence

Rationale

Chronic diseases such as diabetes, hypertension, COPD, and heart and kidney disease are prevalent among Danish adults and are associated with significant morbidity, mortality and socio-economic consequences. The prevalence of chronic diseases is increasing due to better living conditions, development of better medical treatments, and increased life expectancy. This poses a significant health challenge, both nationally and globally, and is further complicated by the fact that the growing burden of chronic diseases is leading to an increasing incidence of multimorbidity. The treatment of chronic diseases often requires long-term pharmacological treatment, where a person's ability to follow the prescribed treatment regimen (called adherence) plays a crucial role in determining their prognosis. Reduced adherence can have serious consequences for both the individual and society as a whole. The term 'adherence' refers to the extent to which a person's behaviour (intake of medication, diet, exercise, etc.) is in line with recommendations from a healthcare professional that the individual has agreed to. Adherence is influenced by a wide range of factors related to the person, the disease, the treatment and the healthcare system. WHO has estimated that only about 50% of people with chronic diseases are adherent to their drug treatment. However, the extent of reduced adherence among adults with chronic diseases is not well researched in a Danish context. The comprehensive Danish health registries provide a unique opportunity to investigate the extent, development and temporality (temporal correlations) in the occurrence of chronic diseases. At the same time, it is possible to analyse the consequences of reduced adherence to both drug treatment and healthcare services (e.g. no-shows from scheduled examinations) in relation to these conditions. Understanding the temporality and trajectory of chronic diseases, including how adherence is affected and changes over time, is central to developing targeted interventions to improve patient outcomes. Despite significant advances in digital health and advanced data analytics such as machine learning algorithms, there is a limited understanding of how routinely collected health data can be used to monitor and predict adherence to treatment of chronic diseases. By utilising routinely collected health data from the Danish registries, we can gain insight into factors that influence the development of chronic diseases and reduced adherence, and how best to identify people with reduced adherence in clinical practice. This will enable us to develop more targeted initiatives to improve adherence and thweby health outcomes. The aim of the project is to investigate the prevalence of chronic diseases and multimorbidity among adult Danes, including temporality and disease progression, and to relate this to the extent and consequences of reduced adherence. The project will also explore the possibility of monitoring and predicting reduced adherence based on routinely collected health data.

Description of the cohort

The study population consists of adults with chronic diseases, identified based on recorded data on prescription claims and diagnosis codes from danish registries.

Data and biological material

The project is based on data from the Danish national registries, including the Danish national patient registry and the Danish national prescription registry.

Collaborating researchers and departments

Department of Clinical Pharmacology, Odense University Hospital

• Daniel Pilsgaard Henriksen, Chief physician