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Impact of medication burden on adherence with antihypertensive drugs

Descriptive

TypeOfResource
Text
TitleInfo (ID = T-1)
Title
Impact of medication burden on adherence with antihypertensive drugs
Identifier
ETD_2916
Identifier (type = hdl)
http://hdl.rutgers.edu/1782.1/rucore10001600001.ETD.000056348
Language
LanguageTerm (authority = ISO639-2); (type = code)
eng
Genre (authority = marcgt)
theses
Subject (ID = SBJ-1); (authority = RUETD)
Topic
Public Health
Subject (ID = SBJ-2); (authority = ETD-LCSH)
Topic
Hypotensive agents--Administration
Subject (ID = SBJ-3); (authority = ETD-LCSH)
Topic
Drugs--Dosage
Abstract (type = abstract)
Antihypertensive 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.
PhysicalDescription
Form (authority = gmd)
electronic resource
Extent
viii, 137 p. : ill.
InternetMediaType
application/pdf
InternetMediaType
text/xml
Note (type = degree)
Ph.D.
Note (type = bibliography)
Includes bibliographical references
Note (type = vita)
Includes vita
Note (type = statement of responsibility)
by Feride H Frech-Tamas
Name (ID = NAME-1); (type = personal)
NamePart (type = family)
Frech-Tamas
NamePart (type = given)
Feride
NamePart (type = date)
1965-
Role
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author
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Feride Frech-Tamas
Name (ID = NAME-2); (type = personal)
NamePart (type = family)
Schneider
NamePart (type = given)
Dona
Role
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chair
Affiliation
Advisory Committee
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Dona Schneider
Name (ID = NAME-3); (type = personal)
NamePart (type = family)
RHOADS
NamePart (type = given)
GEORGE
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RoleTerm (authority = RULIB)
internal member
Affiliation
Advisory Committee
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GEORGE RHOADS
Name (ID = NAME-4); (type = personal)
NamePart (type = family)
Suh
NamePart (type = given)
Dong-Churl
Role
RoleTerm (authority = RULIB)
internal member
Affiliation
Advisory Committee
DisplayForm
Dong-Churl Suh
Name (ID = NAME-5); (type = personal)
NamePart (type = family)
Arcona
NamePart (type = given)
Stephen
Role
RoleTerm (authority = RULIB)
outside member
Affiliation
Advisory Committee
DisplayForm
Stephen Arcona
Name (ID = NAME-1); (type = corporate)
NamePart
Rutgers University
Role
RoleTerm (authority = RULIB)
degree grantor
Name (ID = NAME-2); (type = corporate)
NamePart
Graduate School - New Brunswick
Role
RoleTerm (authority = RULIB)
school
OriginInfo
DateCreated (qualifier = exact)
2010
DateOther (qualifier = exact); (type = degree)
2010
Place
PlaceTerm (type = code)
xx
RelatedItem (type = host)
TitleInfo
Title
Rutgers University Electronic Theses and Dissertations
Identifier (type = RULIB)
ETD
RelatedItem (type = host)
TitleInfo
Title
Graduate School - New Brunswick Electronic Theses and Dissertations
Identifier (type = local)
rucore19991600001
Location
PhysicalLocation (authority = marcorg); (displayLabel = Rutgers, The State University of New Jersey)
NjNbRU
Identifier (type = doi)
doi:10.7282/T3VM4C1K
Genre (authority = ExL-Esploro)
ETD doctoral
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Rights

RightsDeclaration (AUTHORITY = GS); (ID = rulibRdec0006)
The author owns the copyright to this work.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
RightsHolder (ID = PRH-1); (type = personal)
Name
FamilyName
Frech-Tamas
GivenName
Feride
Role
Copyright Holder
RightsEvent (ID = RE-1); (AUTHORITY = rulib)
Type
Permission or license
DateTime
2010-09-27 15:19:41
AssociatedEntity (ID = AE-1); (AUTHORITY = rulib)
Role
Copyright holder
Name
Feride Frech-Tamas
Affiliation
Rutgers University. Graduate School - New Brunswick
AssociatedObject (ID = AO-1); (AUTHORITY = rulib)
Type
License
Name
Author Agreement License
Detail
I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
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Technical

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ETD
MimeType (TYPE = file)
application/pdf
MimeType (TYPE = container)
application/x-tar
FileSize (UNIT = bytes)
522240
Checksum (METHOD = SHA1)
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