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. 2022 Oct;78(10):1687-1696.
doi: 10.1007/s00228-022-03369-0. Epub 2022 Aug 2.

Non-persistence to antihypertensive drug therapy in Lithuania

Indre Treciokiene  1   2 , Nomeda Bratcikoviene  3   4 , Jolanta Gulbinovic  5 , Bjorn Wettermark  6   7 , Katja Taxis  8
Affiliations

Non-persistence to antihypertensive drug therapy in Lithuania

Indre Treciokiene et al. Eur J Clin Pharmacol. 2022 Oct.

Abstract

Purpose: Poor persistence to antihypertensive therapy is an important cause of treatment failure. Investigating persistence is especially important in countries with a high cardiovascular mortality, like Lithuania. The aim of this study was to describe the antihypertensive treatment at initiation, to determine the percentage of patients not being persistent with antihypertensive treatment after 1 year and to explore factors associated with non-persistence.

Methods: In this cohort study, data on dispensed prescription medicines from the Lithuanian National Health Insurance Fund (NHIF) were used. All adult patients with a diagnosis of hypertension having first antihypertensive dispensed in 2018 were included. Descriptive statistics was used to determine the number of patients started with monotherapy and combination therapy. Treatment choice by Anatomical Therapeutic Chemical (ATC) and number of active pharmaceutical ingredient (API) was described. Non-persistence was assessed using the anniversary method. Multivariate logistic regression was used to explore factors associated with non-persistence.

Results: A total of 72,088 patients were included into the study, 56% started on monotherapy treatment, with 49% being dispensed an angiotensin converting enzyme inhibitor, and 44% started on combination therapy. Overall, 57% of patients were non-persistent after 1 year. Patients' gender and prescriber qualification showed no association with non-persistence. Younger patients, patients from rural area, patients started with monotherapy, and patients with no medication change had higher odds to become non-persistent.

Conclusions: The majority of patients were initiated with treatment following hypertension management guidelines, but it is of concern that over half of the patients were non-persistent to antihypertensive therapy in the first year.

Keywords: Hypertension; Persistence; Real-world data; Treatment initiation.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Measuring persistence with treatment anniversary method
Fig. 2
Fig. 2
Possible differences in treatment between the 1st and the last dispensation
See this image and copyright information in PMC

References

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    1. Health Statistics (2021) https://hi.lt/html/sv_statistika.htm. Accessed 31 Aug 2021

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