Effect of patient and treatment factors on persistence with antihypertensive treatment: A population-based study

Malo, Sara (Universidad de Zaragoza) ; Aguilar-Palacio, Isabel (Universidad de Zaragoza) ; Feja, Cristina ; Lallana, MªJesús ; Armesto, Javier ; Rabanaque, MªJosé (Universidad de Zaragoza)

Resumen: 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.

Idioma: Inglés

DOI: 10.1371/journal.pone.0245610

Año: 2021

Publicado en: PLoS ONE 16, 1 (2021), e0245610 [13 pp.]
ISSN: 1932-6203

Factor impacto JCR: 3.752 (2021)

Categ. JCR: MULTIDISCIPLINARY SCIENCES rank: 29 / 74 = 0.392 (2021) - Q2 - T2

Factor impacto SCIMAGO: 0.852 - Multidisciplinary (Q1)

Financiación: info:eu-repo/grantAgreement/ES/DGA-GRISSA/B09-17R

Tipo y forma: Article (Published version)

Área (Departamento): Área Medic.Prevent.Salud Públ. (Dpto. Microb.Ped.Radio.Sal.Pú.)