Medication adherence to first-line antihypertensive drug class in a large Chinese population

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:167

Article

Wong, Martin C. S.¹  Tam, Wilson W. S.¹  Cheung, Clement S. K.²  Tong, Ellen L. H.²  Sek, Antonio C. H.²  Cheung, N. T.²  Leeder, Stephen³  Griffiths, Sian¹ 

[1] Chinese Univ Hong Kong, Fac Med, Sch Publ Hlth & Primary Care, Hong Kong, Hong Kong, Peoples R China

[2] Hosp Author Informat Technol Serv, Hlth Informat Sect, Hong Kong, Hong Kong, Peoples R China

[3] Univ Sydney, Menzies Ctr Hlth Policy, Sydney, NSW 2006, Australia

关键词: Antihypertensive agents;    First-line;    Adherence;    Associated factors;    Large database;   

DOI  :  10.1016/j.ijcard.2012.04.060

来源: Elsevier

【 摘 要 】

Purpose: Suboptimal adherence to antihypertensive agents leads to adverse clinical outcomes. This study aims to evaluate the association between first-line antihypertensive drug class and medication adherence in a large Chinese population. Methods: All patients prescribed >= one antihypertensive drug in 2001-2003 and 2005 who have paid at least two consecutive clinic visits in the public healthcare system of Hong Kong were included. We excluded patients who have followed-up in the clinics for <= 30 days. Interval-based Proportion of Days Covered (PDC) was used to assess medication adherence. All patients were followed-up for up to 5 years. Binary logistic regression analysis was used to evaluate the factors associated with optimal adherence, defined as PDC >= 80%. Results: From 147,914 eligible patients, 69.2% were adherent to the antihypertensive prescriptions. When compared with angiotensin converting enzyme inhibitors (ACEIs), patients initially prescribed alpha-blockers (adjusted odds ratio [AOR]=0.234, 95% C. I. 0.215-0.256), beta-blockers (AOR=0.447, 95% C. I. 0.420, 0.477), thiazide diuretics (AOR=0.431 95% C. I. 0.399, 0.466) and calcium channel blockers (AOR=0.451, 95% C. I. 0.423, 0.481) were significantly less likely to be drug adherers. Angiotensin receptor blockers (ARBs) and fixed-dose combination therapies were similarly likely to be medication adherent. Older age, male gender, visits in general out-patient clinics, residence in urbanized regions, and the presence of comorbidity were positively associated with optimal drug adherence. Conclusion: Patients receiving initial prescriptions of ACEIs, ARB and combination therapy had more favorable adherence profiles than the other major antihypertensive classes in real-life clinical practice. (C) 2012 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

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