PURPOSE: Practice patterns were investigated for an insured population to determine if prescribing patterns, switching, and relative adherence by drug class for first-line antihypertensive medications adhered to national guidelines. PROCEDURES: Drug use was obtained from pharmaceutical claims. Prescriptions were categorized into 6 drug classes for analyses. Adherence with antihypertensive medications was based on a medication possession ratio or 0.8 or greater. For the analyses, 28,073 patients were categorized into groups: hypertension alone, hypertension plus diabetes, and hypertension plus congestive heart failure. Patient and physician characteristics affecting prescribing, switching, and adherence were analyzed using multivariable logistic regression analysis. FINDINGS: Thiazide diuretics were used and adhered to less often, despite national guideline recommendations. New drug classes were used more highly. CONCLUSIONS: Inconsistency exists between guidelines and practice as older, cheaper drugs were used less and more expensive drugs were used more often with better adherence.
PURPOSE: Practice patterns were investigated for an insured population to determine if prescribing patterns, switching, and relative adherence by drug class for first-line antihypertensive medications adhered to national guidelines. PROCEDURES: Drug use was obtained from pharmaceutical claims. Prescriptions were categorized into 6 drug classes for analyses. Adherence with antihypertensive medications was based on a medication possession ratio or 0.8 or greater. For the analyses, 28,073 patients were categorized into groups: hypertension alone, hypertension plus diabetes, and hypertension plus congestive heart failure. Patient and physician characteristics affecting prescribing, switching, and adherence were analyzed using multivariable logistic regression analysis. FINDINGS: Thiazide diuretics were used and adhered to less often, despite national guideline recommendations. New drug classes were used more highly. CONCLUSIONS: Inconsistency exists between guidelines and practice as older, cheaper drugs were used less and more expensive drugs were used more often with better adherence.
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