Persistence with Antihypertensive Medications in Uncomplicated Treatment-Naive Patients: Effects of Initial Therapeutic Classes
Journal of Korean Medical Science
;
: 1800-1806, 2015.
Article
in English
| WPRIM
| ID: wpr-164155
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.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Angiotensin-Converting Enzyme Inhibitors
/
Calcium Channel Blockers
/
Retrospective Studies
/
Cohort Studies
/
Adrenergic beta-Antagonists
/
Sodium Chloride Symporter Inhibitors
/
Medication Adherence
/
Republic of Korea
/
Angiotensin Receptor Antagonists
/
Hypertension
Type of study:
Etiology study
/
Incidence study
/
Observational study
/
Risk factors
Limits:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
English
Journal:
Journal of Korean Medical Science
Year:
2015
Type:
Article
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