A retrospective, population-based analysis of persistence with antihypertensive drug therapy in primary care practice in Italy

Esposti, Luca Degli; Esposti, Ezio Degli; Valpiani, Giorgia; Martino, Mirko Di; Saragoni, Stefania; Buda, Stefano; Baio, Gianluca; Capone, Alessandro; Sturani, A

doi:10.1016/s0149-2918(02)80039-x

Cited by 93 publications

(73 citation statements)

References 22 publications

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“…As many as 60% of hypertensive patients discontinue their treatment within the first year of care (70)(71)(72), and fewer than 65% remain in therapy after three years (72,73). Of those remaining in treatment, antihypertensive medication adherence varies from 40% to 70% (74)(75)(76).…”

Section: Discussionmentioning

confidence: 99%

Take Control of Your Blood pressure (TCYB) study: A multifactorial tailored behavioral and educational intervention for achieving blood pressure control

Bosworth

Olsen

Neary

et al. 2008

Patient Education and Counseling

139

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Objectives-Evaluating a randomized controlled trial involving a tailored behavioral intervention conducted to improve blood pressure control.Methods-Adults with hypertension from two outpatient primary care clinics were randomly allocated to receive a nurse-administered behavioral intervention or usual care. In this ongoing study, patients receive the tailored behavioral intervention bi-monthly for two years via telephone; the goal of the intervention is to promote medication adherence and improve hypertension-related health behaviors. Patient factors targeted in the tailored behavioral intervention include perceived risk of hypertension and knowledge, memory, medical and social support, patients' relationship with their health care provider, adverse effects of medication therapy, weight management, exercise, diet, stress, smoking, and alcohol use.Results-The sample randomized to the behavioral intervention consisted of 319 adults with hypertension (average age = 60.5 years; 47% African-American). A comparable sample of adults was assigned to usual care (n=317). We had a 96% retention rate for the overall sample for the first 6 months of the study (93% at 12 months). The average phone call has lasted 18 minutes (range 2 to 51 minutes). From baseline to six months, self-reported medication adherence increased by 9% in the behavioral group vs. 1% in the non-behavioral group.Conclusion-The intervention is easily implemented and is designed to enhance adherence with prescribed hypertension regimen. The study includes both general and patient-tailored information based upon need assessment. The study design ensures internal validity as well as the ability to generalize study findings to the clinic settings. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Practice Implications-Despite knowledge of the risks and acceptable evidence, a large number of hypertensive adults still do not have their blood pressure under effective control. This study will be an important step in evaluating a tailored multibehavioral intervention focusing on improving blood pressure control. NIH Public Access

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Section: Discussionmentioning

confidence: 99%

Take Control of Your Blood pressure (TCYB) study: A multifactorial tailored behavioral and educational intervention for achieving blood pressure control

Bosworth

Olsen

Neary

et al. 2008

Patient Education and Counseling

139

123

View full text Add to dashboard Cite

show abstract

“…Seventeen studies described in 19 papers (33,45,51,58,60,72,76,79,80,83,(87)(88)(89)(90)(91)(92)(93)(94)(95) reported quantitative information on persistence or adherence. We operationally defined adherence as the consistency with which medica- The first group is observational studies and the second group is randomized, controlled trials.…”

Section: Adherence and Persistencementioning

confidence: 99%

Systematic Review: Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers for Treating Essential Hypertension

et al. 2008

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“…starting AHD therapy, we have chosen as reference ARB because they have an antihypertensive effect similar to other classes of AHD but less side effects [24] and more adherence to treatment [25,26]. The use of diuretics as starting drug increases the risk of outcomes in the three cohorts.…”

Section: Discussionmentioning

confidence: 99%

Effect of antihypertensive therapy on hospitalization and mortality among uncomplicated and high risk hypertensive patients

Esposti¹,

Saragoni²,

Veronesi³

et al. 2013

Health

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and older (66.4 ± 11.6, 67.5 ± 13.2 VS 61.6 ± 13.9) than hypertensive patients and were more treated with concomitant therapy. Drugs acting on the renin-angiotensin system were the more frequent choice in the three cohorts but with a different prevalence (63.9%, 52.9%, 35.9% in diabetic, hypertensive and high risk patients respectively). Adherent patients to AHD (PDC > 80%) were 44.0% among diabetic patients, 48.4% among high risk, 35.2% among hypertensive. A Cox regression model showed that the risk of the combined outcome was determined by increasing age, male gender, presence of concomitant therapy, low adherence to AHD and first choice of AHD. Conclusions: An integrated analysis of prescription and hospital discharge database has the great advantage that it uses routinely available data, it can be done quickly and by few staff, and it is less expensive than planned large scale survey.

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A retrospective, population-based analysis of persistence with antihypertensive drug therapy in primary care practice in Italy

Cited by 93 publications

References 22 publications

Take Control of Your Blood pressure (TCYB) study: A multifactorial tailored behavioral and educational intervention for achieving blood pressure control

Take Control of Your Blood pressure (TCYB) study: A multifactorial tailored behavioral and educational intervention for achieving blood pressure control

Systematic Review: Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers for Treating Essential Hypertension

Effect of antihypertensive therapy on hospitalization and mortality among uncomplicated and high risk hypertensive patients

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