Persistence with Antihypertensive Medications in Uncomplicated Treatment-Naive Patients: Effects of Initial Therapeutic Classes.
10.3346/jkms.2015.30.12.1800
- Author:
Young Mi AH
1
;
Ju Yeun LEE
;
Yun Jung CHOI
;
Baegeum KIM
;
Kyung Hee CHOI
;
Jisun KONG
;
Jung Mi OH
;
Wan Gyoon SHIN
;
Hae Young LEE
Author Information
1. College of Pharmacy, Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, Korea. jypharm@hanyang.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Uncomplicated Hypertension;
Persistence;
Adherence;
Therapeutic Class
- MeSH:
Adolescent;
Adrenergic beta-Antagonists/therapeutic use;
Adult;
Aged;
Aged, 80 and over;
Angiotensin Receptor Antagonists/therapeutic use;
Angiotensin-Converting Enzyme Inhibitors/therapeutic use;
Antihypertensive Agents/classification/*therapeutic use;
Calcium Channel Blockers/therapeutic use;
Cohort Studies;
Female;
Humans;
Hypertension/*drug therapy;
Male;
Medication Adherence;
Middle Aged;
Republic of Korea;
Retrospective Studies;
Sodium Chloride Symporter Inhibitors/therapeutic use;
Young Adult
- From:Journal of Korean Medical Science
2015;30(12):1800-1806
- CountryRepublic of Korea
- Language:English
-
Abstract:
We aimed to assess one-year persistence with antihypertensive therapy (AHT) among newly treated uncomplicated hypertensive patients in Korea and to evaluate the effect of initial therapeutic classes on persistence. We retrospectively analyzed a random sample of 20% of newly treated uncomplicated hypertensive patients (n = 45,787) in 2012 from the National Health Insurance claims database. This group was classified into six cohorts based on initial AHT class. We then measured treatment persistence, allowing a prescription gap of 60 days. Adherence to AHT was assessed with the medication possession ratio. Calcium channel blockers (CCB, 43.7%) and angiotensin receptor blockers (ARB, 40.3%) were most commonly prescribed as initial monotherapy. Overall, 62.1% and 42.0% were persistent with any AHT and initial class at one year, respectively, and 64.2% were adherent to antihypertensive treatment. Compared with ARBs, the risk of AHT discontinuation was significantly increased with initial use of thiazide diuretics (hazard ratio [HR], 3.16; 95% confidence interval [CI] 2.96-3.74) and beta blockers (HR, 1.86; CI, 1.77-1.95) and was minimally increased with CCBs (HR, 1.12; CI, 1.08-1.15). In conclusion, persistence and adherence to AHT are suboptimal, but the differences are meaningful in persistence and adherence between initial AHT classes.
