TY - JOUR
T1 - Antihypertensive Medication Nonpersistence and Low Adherence for Adults <65 Years Initiating Treatment in 2007-2014
AU - Tajeu, Gabriel S.
AU - Kent, Shia T.
AU - Huang, Lei
AU - Bress, Adam P.
AU - Cuffee, Yendelela
AU - Halpern, Michael T.
AU - Kronish, Ian M.
AU - Krousel-Wood, Marie
AU - Mefford, Matthew T.
AU - Shimbo, Daichi
AU - Muntner, Paul
N1 - Funding Information:
G.S. Tajeu was supported by NIH/NHLBI 5T32 HL00745733 and NIH/NIDDK 3R01DK108628-05S1. I.M. Kronish was supported by R01-HL123368 and R01 HS024262. M. Krousel-Wood was supported by 5K12HD043451-14, 1 U54 GM104940, UL1TR001417, 1 R01 HL130500-01A1, R01 HL133790, 1 R21 LM012448-2, and 1P20GM109036-01A1. D. Shimbo was supported by NHLBI K24- HL125704. A.P. Bress was supported by NHLBI 1K01HL133468-01. M.T. Mefford was supported by AHRQ 5T32 HS013852-15.
Funding Information:
G.S. Tajeu was supported by NIH/NHLBI 5T32 HL00745733 and NIH/NIDDK 3R01DK108628-05S1. I.M. Kronish was supported by R01-HL123368 and R01 HS024262. M. Krousel-Wood was supported by 5K12HD043451-14, 1 U54 GM104940, UL1TR001417, 1 R01 HL130500-01A1, R01 HL133790, 1 R21 LM012448-2, and 1P20GM109036-01A1. D. Shimbo was supported by NHLBI K24-HL125704. A.P. Bress was supported by NHLBI 1K01HL133468-01. M.T. Mefford was supported by AHRQ 5T32 HS013852-15.
Publisher Copyright:
© 2019 American Heart Association, Inc.
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Previous evidence suggests modest improvements in antihypertensive medication adherence occurred from 2007 to 2012 among US adults ≥65 years of age. Whether adherence improved over time among adults <65 years of age is unknown. We assessed trends in antihypertensive medication nonpersistence and low adherence among 379 658 commercially insured adults <65 years of age initiating treatment in 2007-2014 using MarketScan claims. Nonpersistence was defined as having no days of medication available to take during the final 90 days of the 365 days following initiation. Among beneficiaries who were persistent to treatment, low adherence was defined by having antihypertensive medication available to take for <80% of the days in the 365 days following initiation (ie, proportion of days covered <80%). In 2007 and 2014, 23.3% and 23.5% of patients were nonpersistent to treatment, respectively, and 42.3% and 40.2% had low adherence, respectively. The relative risks for nonpersistence and low adherence were lower among beneficiaries initiating treatment with an angiotensin-converting enzyme inhibitor (0.95; 95% CI, 0.94-0.97 and 0.97; 95% CI, 0.96-0.98, respectively), angiotensin receptor blocker (0.86; 95% CI, 0.85-0.88 and 0.99; 95% CI, 0.97-1.00, respectively), or multiclass regimen (0.82; 95% CI, 0.80-0.84 and 0.88; 95% CI, 0.86-0.89, respectively), prescribed 90-day versus 30-day prescriptions (0.67; 95% CI, 0.66-0.68 and 0.70; 95% CI, 0.69-0.71, respectively), or who received medications by mail versus at the pharmacy (0.93; 95% CI, 0.90-0.95 and 0.90; 95% CI, 0.88-0.92, respectively). In conclusion, several modifiable factors were associated with lower rates of both antihypertensive medication nonpersistence and low adherence among adults <65 years of age initiating treatment in 2007-2014.
AB - Previous evidence suggests modest improvements in antihypertensive medication adherence occurred from 2007 to 2012 among US adults ≥65 years of age. Whether adherence improved over time among adults <65 years of age is unknown. We assessed trends in antihypertensive medication nonpersistence and low adherence among 379 658 commercially insured adults <65 years of age initiating treatment in 2007-2014 using MarketScan claims. Nonpersistence was defined as having no days of medication available to take during the final 90 days of the 365 days following initiation. Among beneficiaries who were persistent to treatment, low adherence was defined by having antihypertensive medication available to take for <80% of the days in the 365 days following initiation (ie, proportion of days covered <80%). In 2007 and 2014, 23.3% and 23.5% of patients were nonpersistent to treatment, respectively, and 42.3% and 40.2% had low adherence, respectively. The relative risks for nonpersistence and low adherence were lower among beneficiaries initiating treatment with an angiotensin-converting enzyme inhibitor (0.95; 95% CI, 0.94-0.97 and 0.97; 95% CI, 0.96-0.98, respectively), angiotensin receptor blocker (0.86; 95% CI, 0.85-0.88 and 0.99; 95% CI, 0.97-1.00, respectively), or multiclass regimen (0.82; 95% CI, 0.80-0.84 and 0.88; 95% CI, 0.86-0.89, respectively), prescribed 90-day versus 30-day prescriptions (0.67; 95% CI, 0.66-0.68 and 0.70; 95% CI, 0.69-0.71, respectively), or who received medications by mail versus at the pharmacy (0.93; 95% CI, 0.90-0.95 and 0.90; 95% CI, 0.88-0.92, respectively). In conclusion, several modifiable factors were associated with lower rates of both antihypertensive medication nonpersistence and low adherence among adults <65 years of age initiating treatment in 2007-2014.
KW - epidemiology
KW - hypertension
KW - medication adherence
KW - risk factors
UR - http://www.scopus.com/inward/record.url?scp=85068197738&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85068197738&partnerID=8YFLogxK
U2 - 10.1161/HYPERTENSIONAHA.118.12495
DO - 10.1161/HYPERTENSIONAHA.118.12495
M3 - Article
C2 - 31132956
AN - SCOPUS:85068197738
SN - 0194-911X
VL - 74
SP - 35
EP - 46
JO - Hypertension
JF - Hypertension
IS - 1
ER -