Men and women with hypertension and men with diabetes were 1.3 times to 2.4 times less likely to take their prescription medications after retirement, according to a study in CMAJ (Canadian Medical Association Journal).

Poor adherence to prescription medication is common and can affect the ability to manage hypertension and diabetes, two illnesses linked with heart disease and death. Although substantial research has been conducted on factors that influence medication adherence such as patient demographics, physician and pharmacist characteristics and other factors, little is known about the effects of life changes on medication adherence.

Researchers from Finland, the United Kingdom and Sweden looked at the effect of retirement on medication adherence in a cohort of 21 052 retired government employees in Finland. They linked data on filled prescriptions from national registers to each patient, following them 3 years before retirement to 4 years after retirement. Of the 21 052 retirees, 3468 people had hypertension and 412 had type 2 diabetes in the period before retirement. Median age at retirement was 61 years, and 75% of the total 3880 people were women.

"For men and women with hypertension and men with type 2 diabetes, retirement was linked to 1.3- to 2.4-fold increases in poor medication adherence," says Professor Mika Kivimäki, Department of Epidemiology and Public Health, University College London (UCL), London, United Kingdom. "We saw no significant difference in this adherence pattern between age groups, socioeconomic strata or patients with and without depression or comorbid cardiovascular disease. These patterns suggest that our findings were robust and not limited to a specific group."

The researchers suggest several reasons for the drop in taking medications. The perception that poor health will reduce with retirement, loss of a familiar daily routine or the transition from workplace to nonworkplace health care in Finland could all be factors.

"These findings suggest that retirement may increase medication nonadherence, a timely issue given that the proportion of people aged 65 years or older is growing rapidly. Further research is needed to determine the generalizability of our findings across multiple settings and in other populations," the authors conclude.