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Med J Aust. 2008 Feb 18;188(4):224-7.

Persistence with antihypertensive medication: Australia-wide experience, 2004-2006.

Author information

  • 1Lipid Research Department, University of New South Wales, St Vincent's Hospital, Sydney, NSW, Australia. l.simons@unsw.edu.au

Abstract

OBJECTIVE:

To study persistence and adherence with the use of common antihypertensive (AHT) medications.

DESIGN, SETTING AND PARTICIPANTS:

Longitudinal assessment of Pharmaceutical Benefit Scheme claim records covering the period January 2004 to December 2006. We analysed a 10% random sample of all Australian long-term health concession card holders who had been commenced on an angiotensin II receptor antagonist (A2RA), an angiotensin-converting enzyme inhibitor (ACEI) and/or a calcium channel blocker (CCB), but for whom no AHT medication had been dispensed in the previous 6 months.

MAIN OUTCOME MEASURES:

Proportion of patients failing to fill a second prescription; median persistence time with medication (ie, non-cessation of therapy); persistence with medication over 33 months; median medication possession ratio (MPR, defined as the proportion of prescribed medication actually consumed by patients persisting with treatment).

RESULTS:

The database yielded information relating to 48 690 patients prescribed AHT medication. Nineteen per cent of patients failed to collect a second prescription. The median persistence time was 20 months. The data were little different from the population average with respect to A2RAs or ACEIs, but persistence was 57% poorer with respect to CCBs (log-rank P < 0.001) (28% of patients prescribed CCBs failed to collect a second prescription; median persistence time, 7 months). There were differences in persistence between individual drugs in the respective classes, the best outcomes being with candesartan and telmisartan (A2RAs; 10%-20% better), perindopril (ACEI; 25% better) and lercanidipine (CCB; 25% better). Median MPRs were generally around 100%, indicating that most patients who collected prescriptions also showed good adherence to treatment regimens.

CONCLUSION:

There is an ongoing problem of poor persistence with commonly used AHT medications. This may represent a diminished opportunity for cardiovascular disease prevention.

PMID:
18279129
[PubMed - indexed for MEDLINE]
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