OBJECTIVE: Effective treatment of hypertension requires continued prescribing of antihypertensive medications for many years. Persistence in prescribing habits, however, has been reported to be low. The study described herein - which is completely independent of pharmaceutical sponsors - was undertaken to evaluate persistence with antihypertensive treatment in Germany. METHODS: A total of 13,763 newly diagnosed hypertensive patients were identified in the IMS Disease Analyzer database and observed for 3 years after their first antihypertensive prescription. RESULTS: The median age of the study cohort was 65 years, and 56% were female. One in four patient received no more than three prescriptions within 3 years. Persistence was longest for patients whose initial prescription was for a free combination based on angiotensin converting enzyme inhibitors (median: 392.5 days), followed patients initially receiving a fixed combination, including angiotensin II receptor antagonists (208.5 days) and AIIRA monotherapy (168 days). Persistence was shortest with diuretics (57 days). Across all treatment groups, persistence after 3 years was 15.2%. Insurance status, sex and comorbidities were not found to impact persistence. CONCLUSION: Our data indicate that persistence differs markedly among the drug classes (p < or = 0.001) but that even persistence of the best drug class is not sufficient to provide for an adequate blood pressure control in the population. The largest decline in persistence occurred in the first 3 months of treatment. More research is needed to elucidate the causes of this early drop in persistence and to develop effective means of improving the currently unsatisfactory situation.
OBJECTIVE: Effective treatment of hypertension requires continued prescribing of antihypertensive medications for many years. Persistence in prescribing habits, however, has been reported to be low. The study described herein - which is completely independent of pharmaceutical sponsors - was undertaken to evaluate persistence with antihypertensive treatment in Germany. METHODS: A total of 13,763 newly diagnosed hypertensivepatients were identified in the IMS Disease Analyzer database and observed for 3 years after their first antihypertensive prescription. RESULTS: The median age of the study cohort was 65 years, and 56% were female. One in four patient received no more than three prescriptions within 3 years. Persistence was longest for patients whose initial prescription was for a free combination based on angiotensin converting enzyme inhibitors (median: 392.5 days), followed patients initially receiving a fixed combination, including angiotensin II receptor antagonists (208.5 days) and AIIRA monotherapy (168 days). Persistence was shortest with diuretics (57 days). Across all treatment groups, persistence after 3 years was 15.2%. Insurance status, sex and comorbidities were not found to impact persistence. CONCLUSION: Our data indicate that persistence differs markedly among the drug classes (p < or = 0.001) but that even persistence of the best drug class is not sufficient to provide for an adequate blood pressure control in the population. The largest decline in persistence occurred in the first 3 months of treatment. More research is needed to elucidate the causes of this early drop in persistence and to develop effective means of improving the currently unsatisfactory situation.
Authors: Katharina Wolf-Maier; Richard S Cooper; José R Banegas; Simona Giampaoli; Hans-Werner Hense; Michel Joffres; Mika Kastarinen; Neil Poulter; Paola Primatesta; Fernando Rodríguez-Artalejo; Birgitta Stegmayr; Michael Thamm; Jaakko Tuomilehto; Diego Vanuzzo; Fenicia Vescio Journal: JAMA Date: 2003-05-14 Impact factor: 56.272
Authors: Richard S Cooper; Katharina Wolf-Maier; Amy Luke; Adebowale Adeyemo; José R Banegas; Terrence Forrester; Simona Giampaoli; Michel Joffres; Mika Kastarinen; Paola Primatesta; Birgitta Stegmayr; Michael Thamm Journal: BMC Med Date: 2005-01-05 Impact factor: 8.775
Authors: Benjamin J Powers; Remy R Coeytaux; Rowena J Dolor; Vic Hasselblad; Uptal D Patel; William S Yancy; Rebecca N Gray; R Julian Irvine; Amy S Kendrick; Gillian D Sanders Journal: J Gen Intern Med Date: 2011-12-07 Impact factor: 5.128
Authors: Miriam Qvarnström; Thomas Kahan; Helle Kieler; Lena Brandt; Jan Hasselström; Kristina Bengtsson Boström; Karin Manhem; Per Hjerpe; Björn Wettermark Journal: Eur J Clin Pharmacol Date: 2013-07-16 Impact factor: 2.953
Authors: Martin Wawruch; Dusan Zatko; Gejza Wimmer; Jan Luha; Sona Wimmerova; Petra Matalova; Peter Kukumberg; Jan Murin; Tomas Tesar; Beata Havelkova; Rashmi Shah Journal: Clin Drug Investig Date: 2017-11 Impact factor: 2.859