Description
TitleImpact of medication burden on adherence with antihypertensive drugs
Date Created2010
Other Date2010 (degree)
Extentviii, 137 p. : ill.
DescriptionAntihypertensive drug adherence is key in achieving blood pressure control and preventing cardiovascular complications. The objective of this study was to
understand how pill burden, age and comorbid conditions impact antihypertensive medication compliance. This retrospective study used
MarketScan claims to identify continuously enrolled adults with newly diagnosed hypertension, follow‐up 6‐month pre‐ and 12–month post‐index antihypertensive
prescription. Pill burden was defined as total number of prescriptions per month and/or doses per day. Medication possession ratio (MPR), defined as total number of index antihypertensive days’ supply divided by 365, was a proxy for compliance. MPR ≥ 0.80 was classified as high. Descriptive statistics were conducted for 27 variables including sociodemographic characteristics, comorbid conditions, health care resource utilization and costs. Logistic regression analysis was run (SAS, version 8.2, Cary, NC). Mean age was 53 years for 68,538 study subjects and 56% were female. Diabetes (18%) and other forms of heart disease (14%) were most prevalent. Most subjects were full‐time employees (64%), working in manufacturing/durable goods (36%) or transportation/communications/utilities (21%), and residing in the South (41%) or North Central (28%) United States. Preferred provider organizations
(41%) and comprehensive benefit plans (23%) provided coverage for most subjects. Approximately 25% of subjects received diuretics, 21% angiotensin‐converting
enzyme inhibitors, 20% beta‐blockers, 17% fixed‐dose combinations, 9% calciumchannel blockers, and 8% angiotensin receptor blockers (ARBs). Total index
antihypertensive copay was lowest for diuretics ($48.71) and highest for ARBs ($98.12). Mean number of doses per day (excluding antihypertensive prescriptions) was 1.3 and number of prescriptions per month (excluding
antihypertensive prescriptions) was 1.85. Mean MPR was 0.70 and 57% of subjects were highly compliant with antihypertensive medications. Likelihood of
compliance decreased by 10% per additional dose per day, increased by 22.5% per additional prescription per month (excluding antihypertensive medications),
decreased by 10% per additional comorbid conditions, increased by 0.6% per additional year of age, by 1.1% per dollar increase in total copay and was 9% greater
for males (p < 0.0001). Increasing doses per day, comorbid conditions and being female had a negative impact on compliance with antihypertensive medications and may assist in targeting populations for quality improvement initiatives.
NotePh.D.
NoteIncludes bibliographical references
NoteIncludes vita
Noteby Feride H Frech-Tamas
Genretheses, ETD doctoral
Languageeng
CollectionGraduate School - New Brunswick Electronic Theses and Dissertations
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.