Factors Associated With Antihypertensive Drug Discontinuation Among Chinese Patients: A Cohort Study

Wong, Martin C. S.; Jiang, Jianfa; Gibbs, Trevor; Griffiths, Siân

doi:10.1038/ajh.2009.67

Cited by 22 publications

(38 citation statements)

References 32 publications

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“…The economic burden has also been considered an important variable in studies of other chronic diseases among Chinese populations [25,26] . We cannot compare our data with information from other studies or trials on BPH medication therapy since, to our knowledge, the medical insurance status has not been evaluated before.…”

Section: Discussionmentioning

confidence: 99%

Finasteride Adherence-Associated Factors in Chinese Benign Prostatic Hyperplasia Patients

Lin

Jiang²,

Wang³

et al. 2011

Urol Int

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Objectives: Medication noncompliance is a recognized problem worldwide. This study evaluated the factors associated with compliance, discontinuation and switching of finasteride among Chinese benign prostatic hyperplasia patients. Materials and Methods: A retrospective cohort study was conducted with 682 outpatients newly diagnosed with benign prostatic hyperplasia and prescribed with finasteride from January 2008 to December 2009, taken from a database. We evaluated their compliance by medication possession ratios, discontinuation and switching rate after the prescription for an average observation period of 15 months. Multiple association factors were identified and evaluated using multivariate logistic regression analyses. Results: The crude compliance level, discontinuation and switching rates were 29.3, 60.6 and 10.1%, respectively. Older age (≧60 years), combination therapy, medical insurance and chronic comorbidities were positively associated with good compliance. Younger age was significantly associated with drug discontinuation or switching. Those patients on finasteride monotherapy and without medical insurance were significantly associated with discontinuation of drugs. Conclusions: Patients <60 years of age, on monotherapy and without medical insurance were less likely to be compliant with their newly initiated finasteride treatment. Consequently, more efforts should be made among this group to increase treatment adherence.

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Section: Discussionmentioning

confidence: 99%

Finasteride Adherence-Associated Factors in Chinese Benign Prostatic Hyperplasia Patients

Lin

Jiang²,

Wang³

et al. 2011

Urol Int

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“…thiazides, BB, CCB and ACEI) and in other studies (16) with the discontinuation rate of ACEI being higher than with diuretic agents and CCB. Our recent studies (17, 18) conducted on Chinese patients also show that drug discontinuation at 180 days was the highest for BB and ACEI, and the discontinuation rate between ACEI and thiazide was similar. We also found the highest discontinuation rate of ACEI (25·0%) at 48 weeks as compared to BB (19·5%), CCB (14·1%) and thiazide diuretics (22·0%) among elderly Chinese female patients (19).…”

Section: What Is Known and Objectivementioning

confidence: 71%

Discontinuation of angiotensin-converting enzyme inhibitors: a cohort study

Wong

Lau

Jiang

et al. 2011

Journal of Clinical Pharmacy and Therapeutics

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Physicians should pay attention to adherence problems particularly when prescribing ACEI to male patients, those who are older than 70 years, have no comorbidity, live in less urbanized or more rural areas, qualify for fee-waiver, are new attendees of consultations or obtain their ACEI prescriptions in FMSC. Future research should evaluate the reasons for ACEI discontinuation among these higher-risk groups.

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“…17,18 This study used the CDARS (Clinical Data Analysis Reporting System) of the Hospital Authority of Hong Kong, which consists of 7 million patient records, 1 million annual admissions and 13 million ambulatory visits. One of its objectives is to aid in research.…”

Section: Methodsmentioning

confidence: 99%

“…17 Users of b-blockers were found to have the highest discontinuation rates. However, although drug discontinuation (without substitution of another drug class) is largely attributed to patients' follow-up default or medication non-adherence, drug switching is an equally important measure in pharmacoepidemiology studies as its occurrence is more likely linked to antihypertensive side effects and inadequate blood pressure control.…”

Section: Introductionmentioning

confidence: 98%

Switching of antihypertensive drugs among 93 286 Chinese patients: a cohort study

2010

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Antihypertensive drug switching induces substantial public health costs. This cohort study evaluated factors associated with switching of antihypertensive agents 180 days after the first date of prescription among ethnic Chinese patients. We included all adult patients aged > or =18 years, who had paid at least two consecutive visits to all public primary care clinics in one large territory of Hong Kong during the study period from January 2004 to June 2007. Binary logistic regression analyses were carried out with antihypertensive drug switching as an outcome variable, while controlling for age, gender, payment status, service types, district of residence, visit types and the number of comorbidities. Among 93,286 eligible patients, 5281 (5.7%) switched their antihypertensive prescriptions to another drug class within 180 days. Patients aged > or =70 years (adjusted odds ratio (aOR) 0.88, P=0.005), male subjects (aOR 0.87, P<0.001) and follow-up visitors (aOR 0.67, P<0.001) were less likely to have their drugs switched. When compared with thaizide diuretics, all other antihypertensive drug classes were associated with a lower likelihood of drug switching (aOR 0.27-0.69, all P<0.001). Closer observations of drug utilization profiles among these patient groups are recommended, and future studies should evaluate the reasons for drug switching.

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Factors Associated With Antihypertensive Drug Discontinuation Among Chinese Patients: A Cohort Study

Abstract: Discontinuation of antihypertensive drug treatment in ethnic Chinese is more likely to occur in younger, male patients, or those prescribed beta-blockers. These data suggest that more meticulous monitoring of patient adherence is required in patients with these characteristics.

Cited by 22 publications

References 32 publications

Finasteride Adherence-Associated Factors in Chinese Benign Prostatic Hyperplasia Patients

Finasteride Adherence-Associated Factors in Chinese Benign Prostatic Hyperplasia Patients

Discontinuation of angiotensin-converting enzyme inhibitors: a cohort study

Switching of antihypertensive drugs among 93 286 Chinese patients: a cohort study

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