Sara Malo1,2, Isabel Aguilar-Palacio1,2, Cristina Feja2,3, María Jesús Lallana2,4, Javier Armesto4, María José Rabanaque1,2. 1. Department of Preventive Medicine and Public Health, University of Zaragoza, Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain. 2. Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Zaragoza, Spain. 3. Directorate of Public Health, Government of Aragon, Zaragoza, Spain. 4. Aragon Healthcare Service, Zaragoza, Spain.
Abstract
PURPOSE: To analyze patterns of antihypertensive drug use among new users in a Southern European population, and identify patient- and treatment-related factors that influence persistence. METHODS: This is a retrospective observational study of new antihypertensive drug users aged ≥40 years in Aragón, Spain. Information on antihypertensive drugs (2014-2016) prescribed and dispensed at pharmacies via the public health system were collected from a regional electronic population-based pharmacy database. Persistence was assessed using the gap method. Kaplan-Meier and Cox regression analyses were conducted to analyze patterns of use and factors that influence persistence. RESULTS: The 25,582 new antihypertensive drug users in Aragón during the study period were prescribed antihypertensive drugs in monotherapy (73.3%), fixed combination (13.9%), free combination (9.1%), or other (3.7%). One in five received antihypertensive drugs within 15 days of the prescription date, but not after. During the first year of follow-up, 38.6% of the study population remained persistent. The likelihood of treatment discontinuation was higher for participants who were male, aged ≥80 years, and received an antihypertensive drug in monotherapy compared with fixed combination. CONCLUSION: Overall persistence with antihypertensive therapy was poor, and was influenced by the sex, age and type of therapy. Fixed combinations appear to be a good choice for initial therapy, especially in patients with a higher risk of discontinuation. Nonetheless, adverse drug effects and the patient's preferences and clinical profile should be taken into account.
PURPOSE: To analyze patterns of antihypertensive drug use among new users in a Southern European population, and identify patient- and treatment-related factors that influence persistence. METHODS: This is a retrospective observational study of new antihypertensive drug users aged ≥40 years in Aragón, Spain. Information on antihypertensive drugs (2014-2016) prescribed and dispensed at pharmacies via the public health system were collected from a regional electronic population-based pharmacy database. Persistence was assessed using the gap method. Kaplan-Meier and Cox regression analyses were conducted to analyze patterns of use and factors that influence persistence. RESULTS: The 25,582 new antihypertensive drug users in Aragón during the study period were prescribed antihypertensive drugs in monotherapy (73.3%), fixed combination (13.9%), free combination (9.1%), or other (3.7%). One in five received antihypertensive drugs within 15 days of the prescription date, but not after. During the first year of follow-up, 38.6% of the study population remained persistent. The likelihood of treatment discontinuation was higher for participants who were male, aged ≥80 years, and received an antihypertensive drug in monotherapy compared with fixed combination. CONCLUSION: Overall persistence with antihypertensive therapy was poor, and was influenced by the sex, age and type of therapy. Fixed combinations appear to be a good choice for initial therapy, especially in patients with a higher risk of discontinuation. Nonetheless, adverse drug effects and the patient's preferences and clinical profile should be taken into account.
Authors: Niteesh K Choudhry; Robert J Glynn; Jerry Avorn; Joy L Lee; Troyen A Brennan; Lonny Reisman; Michele Toscano; Raisa Levin; Olga S Matlin; Elliott M Antman; William H Shrank Journal: Am Heart J Date: 2013-10-17 Impact factor: 4.749
Authors: F F Alharbi; P C Souverein; M C de Groot; A H Maitland-van der Zee; A de Boer; O H Klungel Journal: J Hum Hypertens Date: 2017-03-23 Impact factor: 3.012
Authors: Dena Ettehad; Connor A Emdin; Amit Kiran; Simon G Anderson; Thomas Callender; Jonathan Emberson; John Chalmers; Anthony Rodgers; Kazem Rahimi Journal: Lancet Date: 2015-12-24 Impact factor: 79.321
Authors: José R Banegas; Auxiliadora Graciani; Juan J de la Cruz-Troca; Luz M León-Muñoz; Pilar Guallar-Castillón; Antonio Coca; Luis M Ruilope; Fernando Rodríguez-Artalejo Journal: Hypertension Date: 2012-09-04 Impact factor: 10.190
Authors: Miriam Qvarnström; Thomas Kahan; Helle Kieler; Lena Brandt; Jan Hasselström; Kristina Bengtsson Boström; Karin Manhem; Per Hjerpe; Björn Wettermark Journal: Medicine (Baltimore) Date: 2016-10 Impact factor: 1.889
Authors: Konsta Teppo; Jussi Jaakkola; Fausto Biancari; Olli Halminen; Miika Linna; Jari Haukka; Jukka Putaala; Paula Tiili; Ossi Lehtonen; Mikko Niemi; Pirjo Mustonen; Janne Kinnunen; Juha Hartikainen; K E Juhani Airaksinen; Mika Lehto Journal: Pharmacol Res Perspect Date: 2022-06
Authors: Krzysztof J Filipiak; Miguel Camafort Babkowski; Matteo Cameli; Stefano Carugo; Claudio Ferri; Djamshid B Irisov; Krzysztof Narkiewicz; Ulugbek Nizamov; Leopoldo Pérez de Isla; Anna Tomaszuk-Kazberuk; Andrea Ungar; Aleksandra Gąsecka Journal: Cardiol J Date: 2022-09-19 Impact factor: 3.487