Antihypertensive Drug Persistence and Compliance Among Newly Treated Elderly Hypertensives in Ontario

作者：Friedman Oded^*; McAlister Finlay A; Yun Lingsong; Campbell Norman R C; Tu Karen

来源：American Journal of Medicine, 2010, 123(2): 173-181.

DOI：10.1016/j.amjmed.2009.09.008

• Antihypertensive drugs
• Compliance
• Hypertension
• Persistence

BACKGROUND: Poor medication-taking behaviors are important considerations in the management of hypertension.
METHODS: We conducted a retrospective cohort study addressing antihypertensive drug persistence and compliance by linking 4 administrative databases and it province-wide clinical database in Ontario, Canada, to derive a cohort of elderly hypertensive patients, aged 66 years or more, who had received a new prescription for an antihypertensive agent between 1997 and 2005 to determine trends across years and associations with drug class and sociodemographic and other factors.
RESULTS: Our cohort consisted of 207,473 patients (58.4% were women, mean age 74.2 years, 73.1% were comorbid-free), 41,236 of whom had diabetes. Persistence and compliance increased between 1997 and 2005 (all P < .02) and were greater in those of higher socioeconomic status but lesser in urban residents (all P < .0001). Persistence was lower in comorbid-free patients and greater in older patients, whereas compliance was lower in older patients and greater in women and comorbid-free patients (all P < .0001). Significant differences between the drug classes emerged with initial prescriptions for all drug classes showing greater therapy and class persistence compared with diuretics (all P < .0001). Angiotensin-converting enzyme inhibitors showed the best therapy persistence and compliance, and beta-blockers showed the worst compliance (all P < .0001).
CONCLUSION: Our data provide evidence of an overall improvement in antihypertensive drug compliance and persistence across years, as well as significant differences across drug classes and other patient-level factors. Awareness Of Such factors could translate into concerted efforts at optimizing medication-taking behaviors among newly diagnosed elderly hypertensive patients.

• 出版日期2010-2