Discontinuation of antihypertensive drugs among newly diagnosed hypertensive patients in UK general practice

Burke, Thomas; Sturkenboom, Miriam; Lu, Shou‐En; Wentworth, Charles; Lin, Yunfeng; Rhoads, George G.

doi:10.1097/01.hjh.0000226211.95936.f5

Cited by 136 publications

(116 citation statements)

References 27 publications

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“…In agreement with other reports, [22][23][24][25][26] in our setting, more than 55% of patients had already discontinued treatment after 1 year since starting therapy. Poor socioeconomic status has been found to be related to the lack of adherence in antihypertensive drugs in previous studies.…”

Section: Discussionsupporting

confidence: 81%

“…This avoids differential misclassification due to over-reporting of adherence likely related to socioeconomic factors. 36 With respect to other studies based upon general practice databases, 23,25 we included all the patients newly treated for hypertension generated from a welldefined dynamic population. This avoids the selection of patients who are assisted by physicians with higher adherence to guidelines for hypertension treatment.…”

Section: Discussionmentioning

confidence: 99%

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Do socioeconomic disparities affect accessing and keeping antihypertensive drug therapy? Evidence from an Italian population-based study

et al. 2008

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Do socioeconomic disparities affect accessing and keeping antihypertensive drug therapy? Evidence from an Italian population-based study

et al. 2008

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“…The observed rate of non-adherence did not differ significantly from other reports that used different techniques to assess the adherence. [11][12][13] Compared with other approaches, however, the evaluation of SDL provides a reliable method to assess the actual adherence to the recommended therapy.…”

Section: Discussionmentioning

confidence: 99%

Difficult-to-control arterial hypertension or uncooperative patients? The assessment of serum antihypertensive drug levels to differentiate non-responsiveness from non-adherence to recommended therapy

et al. 2010

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Difficult-to-control arterial hypertension is a common medical problem that may result from severe hypertensive disease or from poor adherence to the recommended medical treatment. The identification of non-adherent patients is challenging, especially when non-adherence is intentional. The current report describes the use of serum levels of prescribed antihypertensive drugs to evaluate the adherence in individuals with difficult-to-control arterial hypertension. Serum drug levels (SDLs) were evaluated by liquid chromatography with mass spectrometry. The chromatographic separation was performed on a reversed-phase column with a gradient flow of the mobile phase. The detection of analyzed substances was accomplished on a linear ion-trap mass spectrometer. The subjects were labeled as non-adherent when the serum level of at least one of the evaluated drugs was below the limit of quantification. The study used data from 84 patients with arterial hypertension who underwent SDL assessment to verify compliance with the recommended treatment. Patients who presented with uncontrolled blood pressure despite the recommended combination of at least three antihypertensives were enrolled in the analysis. Based on the evaluation of the SDLs, all of the evaluated drugs were found in the sera of 29 (34.5%) of the study patients. In the remaining 55 (65.5%) patients, non-adherence was diagnosed. None of the prescribed antihypertensive drugs was detected in the sera of the 29 (34.5%) patients. Our data suggest that an assessment of SDLs might be helpful before an extensive evaluation is initiated for difficult-to-control hypertension.

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“…Overall, 25.2 % received three or fewer prescriptions within 3 years. This tendency was endorsed by Burke et al (2006) who surveyed discontinuation rates in 109,454 newly diagnosed hypertensive patients. Discontinuation was defined as no prescription issued within 90 days following the most recent prescription expiration.…”

Section: Thrombophilia/factor V Leidenmentioning

confidence: 98%

Patient compliance based on genetic medicine: a literature review

Schneider

Schmidtke

2013

J Community Genet

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For this literature review, medical literature data bases were searched for studies on patient compliance after genetic risk assessment. The review focused on conditions where secondary or tertiary preventive options exist, namely cancer syndromes (BRCA-related cancer, HNPCC/colon cancer), hemochromatosis, thrombophilia, smoking cessation, and obesity. As a counterpart, patient compliance was assessed regarding medication adherence and medical advice in some of the most epidemiologically important conditions (including high blood pressure, metabolic syndrome, and coronary heart disease) after receiving medical advice based on nongenetic risk information or a combination of genetic and nongenetic risk information. In the majority of studies based on genetic risk assessments, patients were confronted with predictive rather than diagnostic genetic profiles. Most of the studies started from a knowledge base around 10 years ago when DNA testing was at an early stage, limited in scope and specificity, and costly. The major result is that overall compliance of patients after receiving a high-risk estimate from genetic testing for a given condition is high. However, significant behavior change does not take place just because the analyte is "genetic." Many more factors play a role in the complex process of behavioral tuning. Without adequate counseling and guidance, patients may interpret risk estimates of predictive genetic testing with an increase in fear and anxiety.

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Discontinuation of antihypertensive drugs among newly diagnosed hypertensive patients in UK general practice

Cited by 136 publications

References 27 publications

Do socioeconomic disparities affect accessing and keeping antihypertensive drug therapy? Evidence from an Italian population-based study

Do socioeconomic disparities affect accessing and keeping antihypertensive drug therapy? Evidence from an Italian population-based study

Difficult-to-control arterial hypertension or uncooperative patients? The assessment of serum antihypertensive drug levels to differentiate non-responsiveness from non-adherence to recommended therapy

Patient compliance based on genetic medicine: a literature review

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