OBJECTIVE: To identify predictors of compliance with antihypertensive combination therapy in a Medicaid population. METHODS: Retrospective medical and pharmacy claims data for Maryland Medicaid patients receiving angiotensin converting enzyme inhibitors (ACEls)/hydrochlorothiazides (HCTZs) or ACEl/calcium channel blockers as fixed-dose combinations or separate agents during the period of January 1, 2002 to December 31, 2004, were analyzed. INCLUSION: Continuously enrolled patients 18 years and older and at least one year of follow-up. Exclusion: Use of fixed-dose combination antihypertensives between January 1, 2002 and June 30, 2002 (to identify incident cohort). Compliance was defined as medication possession ratio greater than or equal to 80%. Multivariate logistic regression was used to predict compliance as a function of age, gender, race, comorbidities (Charlson Comorbidity Index [CCI]), and use of either fixed-dose combination or separate agents. RESULTS: There were 568 patients, 63.73% female, 68.83% African American, median age 52 years, 35.56% on fixed-dose combinations, 72.89% started on ACEI/HCTZ, and 24.82% complied with therapy. Patients younger than 40 years (OR, 0.38; p = .01; 95% CI, 0.18-0.81) and African American (OR, 0.45; p = .0004; 95% CI, 0.29-0.70) were less likely to be compliant than patients older than 60 years and Caucasian, respectively, Patients with a CCI of 1 (OR, 2.11; p = .05; 95% CI, 1.01-4.40) and those on fixed-dose combinations (OR, 1.60; p = .02, 95% CI, 1.06-2.40) were more likely to be compliant than those with higher CCIs and on separate agents, respectively. CONCLUSION: Age, race, comorbidities, and simplified antihypertensive regimens were significant predictors of compliance. Higher compliance rates may enhance cardiovascular disease management outcomes.
OBJECTIVE: To identify predictors of compliance with antihypertensive combination therapy in a Medicaid population. METHODS: Retrospective medical and pharmacy claims data for Maryland Medicaid patients receiving angiotensin converting enzyme inhibitors (ACEls)/hydrochlorothiazides (HCTZs) or ACEl/calcium channel blockers as fixed-dose combinations or separate agents during the period of January 1, 2002 to December 31, 2004, were analyzed. INCLUSION: Continuously enrolled patients 18 years and older and at least one year of follow-up. Exclusion: Use of fixed-dose combination antihypertensives between January 1, 2002 and June 30, 2002 (to identify incident cohort). Compliance was defined as medication possession ratio greater than or equal to 80%. Multivariate logistic regression was used to predict compliance as a function of age, gender, race, comorbidities (Charlson Comorbidity Index [CCI]), and use of either fixed-dose combination or separate agents. RESULTS: There were 568 patients, 63.73% female, 68.83% African American, median age 52 years, 35.56% on fixed-dose combinations, 72.89% started on ACEI/HCTZ, and 24.82% complied with therapy. Patients younger than 40 years (OR, 0.38; p = .01; 95% CI, 0.18-0.81) and African American (OR, 0.45; p = .0004; 95% CI, 0.29-0.70) were less likely to be compliant than patients older than 60 years and Caucasian, respectively, Patients with a CCI of 1 (OR, 2.11; p = .05; 95% CI, 1.01-4.40) and those on fixed-dose combinations (OR, 1.60; p = .02, 95% CI, 1.06-2.40) were more likely to be compliant than those with higher CCIs and on separate agents, respectively. CONCLUSION: Age, race, comorbidities, and simplified antihypertensive regimens were significant predictors of compliance. Higher compliance rates may enhance cardiovascular disease management outcomes.
Authors: Patti L Ephraim; Felicia Hill-Briggs; Debra L Roter; Lee R Bone; Jennifer L Wolff; LaPricia Lewis-Boyer; David M Levine; Hanan J Aboumatar; Lisa A Cooper; Stephanie J Fitzpatrick; Kimberly A Gudzune; Michael C Albert; Dwyan Monroe; Michelle Simmons; Debra Hickman; Leon Purnell; Annette Fisher; Richard Matens; Gary J Noronha; Peter J Fagan; Hema C Ramamurthi; Jessica M Ameling; Jeanne Charlston; Tanyka S Sam; Kathryn A Carson; Nae-Yuh Wang; Deidra C Crews; Raquel C Greer; Valerie Sneed; Sarah J Flynn; Nicole DePasquale; L Ebony Boulware Journal: Contemp Clin Trials Date: 2014-06-21 Impact factor: 2.226
Authors: D M van der Laan; P J M Elders; C C L M Boons; J J Beckeringh; G Nijpels; J G Hugtenburg Journal: J Hum Hypertens Date: 2017-06-29 Impact factor: 3.012
Authors: Alissa C Cyrus; Julie Royer; Dianna D Carroll; Elizabeth A Courtney-Long; Suzanne McDermott; Margaret A Turk Journal: Am J Intellect Dev Disabil Date: 2019-05