OBJECTIVES:: We have previously shown that in Italian region of Lombardy (about 10 million citizens), adherence to antihypertensive treatment is low, and that this is associated with a greater risk of hospitalization for cardiovascular events. In this study, we used a healthcare database to study the factors involved in discontinuation of antihypertensive drug prescriptions in real life. METHODS AND RESULTS:: The analysis was restricted to 493 623 new users of antihypertensive drugs (no prescriptions in the previous 3 years) recruited in 2003, 2006 and 2009. Discontinuation was defined as lack of prescription renewal for at least 3 months. Each patient was followed at most for 1 year. The adjusted risk of treatment discontinuation depended on the type of initial antihypertensive treatment (diuretic monotherapy associated with higher risk) and it was lower in men (-17%) and older (-21 to -29%) patients, in patients with co-treatment with antidiabetic drugs, or hospitalization for cardiovascular or renal disease (-12 to -27%), but greater in patients under co-treatment with antidepressant drugs or hospitalization for concomitant pulmonary, rheumatic, neoplastic or neurological diseases (+9 to +32%). An unexpected relationship between discontinuation of treatment and density of the population of patient's residence, with a much greater discontinuation in metropolitan areas, was observed. CONCLUSIONS:: In a real life setting, discontinuation of antihypertensive treatment is affected in an opposite direction by a large number of factors: type of antihypertensive treatment, co-treatments, clinical conditions and even demographic characteristics of the geographical area where the patient lives. Knowledge of these factors may help the effort to reduce this phenomenon.

Mancia, G., Zambon, A., Soranna, D., Merlino, L., & Corrao, G. (2014). Factors involved in the discontinuation of antihypertensive drug therapy: An analysis from real life data. JOURNAL OF HYPERTENSION, 32(8), 1708-1716 [10.1097/HJH.0000000000000222].

Factors involved in the discontinuation of antihypertensive drug therapy: An analysis from real life data

MANCIA, GIUSEPPE
Primo
;
ZAMBON, ANTONELLA
;
SORANNA, DAVIDE;CORRAO, GIOVANNI
Ultimo
2014

Abstract

OBJECTIVES:: We have previously shown that in Italian region of Lombardy (about 10 million citizens), adherence to antihypertensive treatment is low, and that this is associated with a greater risk of hospitalization for cardiovascular events. In this study, we used a healthcare database to study the factors involved in discontinuation of antihypertensive drug prescriptions in real life. METHODS AND RESULTS:: The analysis was restricted to 493 623 new users of antihypertensive drugs (no prescriptions in the previous 3 years) recruited in 2003, 2006 and 2009. Discontinuation was defined as lack of prescription renewal for at least 3 months. Each patient was followed at most for 1 year. The adjusted risk of treatment discontinuation depended on the type of initial antihypertensive treatment (diuretic monotherapy associated with higher risk) and it was lower in men (-17%) and older (-21 to -29%) patients, in patients with co-treatment with antidiabetic drugs, or hospitalization for cardiovascular or renal disease (-12 to -27%), but greater in patients under co-treatment with antidepressant drugs or hospitalization for concomitant pulmonary, rheumatic, neoplastic or neurological diseases (+9 to +32%). An unexpected relationship between discontinuation of treatment and density of the population of patient's residence, with a much greater discontinuation in metropolitan areas, was observed. CONCLUSIONS:: In a real life setting, discontinuation of antihypertensive treatment is affected in an opposite direction by a large number of factors: type of antihypertensive treatment, co-treatments, clinical conditions and even demographic characteristics of the geographical area where the patient lives. Knowledge of these factors may help the effort to reduce this phenomenon.
Articolo in rivista - Articolo scientifico
antihypertensive drugs; databases; discontinuation; persistence; Antihypertensive Agents; Humans; Hypertension; Medication Adherence; Internal Medicine; Physiology; Cardiology and Cardiovascular Medicine; Medicine (all)
English
1708
1716
9
Mancia, G., Zambon, A., Soranna, D., Merlino, L., & Corrao, G. (2014). Factors involved in the discontinuation of antihypertensive drug therapy: An analysis from real life data. JOURNAL OF HYPERTENSION, 32(8), 1708-1716 [10.1097/HJH.0000000000000222].
Mancia, G; Zambon, A; Soranna, D; Merlino, L; Corrao, G
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/99821
Citazioni
  • Scopus 55
  • ???jsp.display-item.citation.isi??? 49
Social impact