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. 2010:2:113-20.
doi: 10.2147/ceor.s11933. Epub 2010 Jul 28.

Antihypertensive therapy among newly treated patients: An analysis of adherence and cost of treatment over years

Luca Degli Esposti  1 , Stefania Saragoni, Paolo Batacchi, Pierangelo Geppetti, Stefano Buda, Ezio Degli Esposti
Affiliations

Antihypertensive therapy among newly treated patients: An analysis of adherence and cost of treatment over years

Luca Degli Esposti et al. Clinicoecon Outcomes Res. 2010.

Abstract

Objective: To perform a time-trend analysis of adherence and cost of antihypertensive treatment over four years.

Methods: A population-based retrospective cohort study was conducted. We included subjects ≥18 years, and newly treated for hypertension with diuretics, beta-blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, or angiotensin receptor blockers between 01 January 2004 and 31 December 2007. One-year adherence to antihypertensive therapy was calculated and classified as low, low-intermediate, intermediate, high-intermediate, and high. The direct cost of antihypertensive medications was evaluated.

Results: We included data for a total of 105,512 patients. The number of newly treated subjects decreased from 27,334 in 2004 to 23,812 in 2007, as well as antihypertensive drug therapy cost which decreased from €2,654,166 in 2004 to €2,343,221 in 2007. On the other hand, in the same time frame, the percentage of adherent newly treated subjects increased from 22.9% to 28.0%. Compared with subjects initiated on angiotensin receptor blockers (odds ratio [OR] = 1), the risk of nonadherence was higher in those initiated on angiotensin-converting enzyme inhibitors (OR = 1.19), combination therapy (OR = 1.44), beta-blockers (OR = 1.56), calcium channel blockers (OR = 1.67), and diuretics (OR = 4.28).

Conclusions: The findings of the present study indicate that suboptimal adherence to antihypertensive medication occurs in a substantial proportion of treated patients, and improvements in treatment adherence were obtained but are still unsatisfactory.

Keywords: adherence; administrative databases; antihypertensive therapy; cost.

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References

    1. Degli Esposti L, Valpiani G. Pharmacoeconomic burden of undertreating hypertension. Pharmacoeconomics. 2004;22(14):907–928. - PubMed
    1. Robbiano L, Martelli A, Brambilla G. Discrepancies between use of antihypertensive drugs and guidelines indications: Pharmacoeconomic implications. J Hum Hypertens. 2005;19(10):819–822. - PubMed
    1. Rome: Il Pensiero Scientifico Editore; 2008. The use of pharmaceuticals in Italy. National Report 2007.
    1. Psaty BM, Lumley T, Furberg CD, et al. Health outcomes associated with various antihypertensive therapies used as first-line agents: A network meta analysis. JAMA. 2003;289(19):2534–2544. - PubMed
    1. Turnbull F, Blood Pressure Lowering Treatment Trialists’ Collaboration Effects of different blood pressure lowering regimens on major cardiovascular events: Second cycle of prospectively designed overviews. Lancet. 2003;362(9395):1527–1535. - PubMed