
Effects of Initial Antihypertensive Drug Class on Patient Persistence and Compliance in a Usual‐Care Setting in the United States
Author(s) -
Patel Bimal V.,
RemigioBaker Rosemay A.,
Mehta Devi,
Thiebaud Patrick,
FrechTamas Feride,
Preblick Ronald
Publication year - 2007
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/j.1524-6175.2007.07194.x
Subject(s) - medicine , diuretic , hazard ratio , regimen , antihypertensive drug , retrospective cohort study , compliance (psychology) , angiotensin receptor blockers , pharmacy , cohort , persistence (discontinuity) , drug class , pharmacotherapy , calcium channel blocker , cardiology , angiotensin converting enzyme , drug , blood pressure , pharmacology , confidence interval , psychology , geotechnical engineering , family medicine , social psychology , engineering
Antihypertensive treatment regimen persistence and compliance were measured using a retrospective cohort study of pharmacy claims data. Newly treated patients receiving monotherapy with angiotensin II receptor blockers (ARBs), angiotensin‐converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), β‐blockers (BBs), or diuretics were followed for 1 year (N=242,882). A higher proportion of ARB patients (51.9%) were persistent in taking prescribed medication compared with those in the ACEI (48.0%), BB (40.3%), CCB (38.3%), and diuretic groups (29.9%). Compared with patients receiving diuretics, those receiving ARBs (hazard ratio [HR], 0.593; P <.0001), ACEIs (HR, 0.640; P <.0001), CCBs (HR, 0.859; P <.0001), and BBs (HR, 0.819; P <.0001) were all less likely to discontinue therapy. Compliance was similar in ACEI and ARB patients, but patients receiving ARBs and ACEIs had better compliance than those receiving BBs, CCBs, or diuretics. The lesser degree of compliance and persistence observed in patients receiving diuretics compared with other antihypertensive medications may have public health as well as cost implications.