Persistence with antihypertensives in uncomplicated treatment-naïve very elderly patients: a nationwide population-based study

BMC Cardiovascular Disorders

Research Article

Yun Mi Yu¹  Min Jung Chang²  Young-Mi Ah³  Ju-Yeun Lee³  Kyung Hee Choi⁴ 

[1] College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, 103 Daehak-ro, Jongno-gu, 03080, Seoul, South Korea;College of Pharmacy and Yonsei Institute of Pharmaceutical Sciences, Yonsei University, 21983, Incheon, South Korea;College of Pharmacy, Institute of Pharmaceutical Science and Technology, Hanyang University, 55 Hanyangdaehak-ro, Sangnok-gu, 15588, Ansan, Gyeonggi-do, South Korea;College of Pharmacy, Sunchon National University, 255 Jungang-ro, 57922, Suncheon, Jeollanam-do, South Korea;College of Pharmacy, Chonnam National University, 61186, Gwang-Ju, South Korea;

关键词: Hypertension;    Treatment persistence;    Adherence;    Aged;    Very elderly;   

DOI  :  10.1186/s12872-017-0665-4

 received in 2017-03-13, accepted in 2017-08-16,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundLimited studies have evaluated the medication-taking behavior in very elderly hypertensive patients. The aim of this study was to evaluate the persistence and adherence with antihypertensive agents in treatment-naïve patients, along with other related factors, according to age.MethodsAdult (19–64 years), elderly (65–79 years), and very elderly (≥80 years) uncomplicated hypertensive patients starting antihypertensive monotherapy were identified from the National Health Insurance claims database. The first-year treatment persistence and adherence rates measured using the medication possession ratio were assessed and compared in these three age cohorts.ResultsAfter propensity score matching, three age cohorts with 6689 patients each were assembled from 228,925 uncomplicated hypertensive patients who began antihypertensive monotherapy in 2012. The treatment persistence and adherence rates over the first year were the lowest in the very elderly (59.5% and 62.8%, respectively) and highest in the elderly (65.2% and 67.9%, respectively) patients among the three age cohorts (p < 0.001). The adjusted risk for treatment non-persistence was significantly higher in the very elderly (adjusted hazard ratio, 1.20; 95% confidence interval, 1.13–1.27) compared with the elderly. Having more comorbidities, being a beneficiary of medical aid, and having a diagnosis of dementia were unique positive predictors for treatment persistence in the very elderly, along with common predictors such as female sex, dyslipidemia, and an initially chosen antihypertensive therapeutic class other than beta blockers and thiazide diuretics.ConclusionsVery elderly patients were less likely to continue antihypertensive therapy over the first year compared with their younger counterparts. Our findings suggest that a low comorbidity index and lack of medical aid support negatively affect the treatment persistence in this population.

【 授权许可】

CC BY   
© The Author(s). 2017