Medication Adherence

Ho, P. Michael; Bryson, Chris L.; Rumsfeld, John S.

doi:10.1161/circulationaha.108.768986

Cited by 1,251 publications

(702 citation statements)

References 72 publications

(69 reference statements)

Supporting

Mentioning

616

Contrasting

Unclassified

Order By: Relevance

“…Many randomized, control trials demonstrated the benefit of antihypertensive medications (antihypertensives) on reduction of risk for CVD morbidity and mortality 2, 3. Despite the benefit of antihypertensive therapies, many studies suggested suboptimal adherence to these medications, particularly among older adults with multiple chronic conditions 4, 5, 6, 7, 8, 9, 10, 11. Nonadherence to antihypertensives is associated with increased risk for CVD, hospitalization, and healthcare costs 5, 12, 13, 14, 15, 16, 17.…”

Section: Introductionmentioning

confidence: 99%

“…Despite the benefit of antihypertensive therapies, many studies suggested suboptimal adherence to these medications, particularly among older adults with multiple chronic conditions 4, 5, 6, 7, 8, 9, 10, 11. Nonadherence to antihypertensives is associated with increased risk for CVD, hospitalization, and healthcare costs 5, 12, 13, 14, 15, 16, 17. Many observational studies examined the relationship between antihypertensive adherence and CVD outcomes in the general hypertension population 5, 13, 17.…”

Section: Introductionmentioning

confidence: 99%

“…Nonadherence to antihypertensives is associated with increased risk for CVD, hospitalization, and healthcare costs 5, 12, 13, 14, 15, 16, 17. Many observational studies examined the relationship between antihypertensive adherence and CVD outcomes in the general hypertension population 5, 13, 17. While some focused on older adults,4, 9, 18, 19, 20 few examined this relationship among older adults who were newly initiated on antihypertensives without previous CVD.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Antihypertensive Medication Adherence and Risk of Cardiovascular Disease Among Older Adults: A Population‐Based Cohort Study

Yang

Chang

Ritchey

et al. 2017

JAHA

View full text Add to dashboard Cite

BackgroundAntihypertension medication (antihypertensive) adherence lowers risk of cardiovascular disease (CVD); few studies have examined this association among older adults.Methods and ResultsWe assessed this association among Medicare fee‐for‐service beneficiaries aged 66 to 79 years who were newly diagnosed with hypertension and initiated on antihypertensives in 2008–2009 (n=155 597). We calculated proportion of days covered (PDC) during follow‐up, using proportional subdistribution hazard models, to examine association between antihypertensive adherence and a composite CVD outcomes, including first incident of fatal/nonfatal acute myocardial infarction, ischemic heart disease, stroke/transient ischemic attack, and heart failure. During follow‐up (median 5.8 years and 798 621 person‐years), we documented 47 198 CVD events. Among beneficiaries, 60.8%, 30.3%, and 8.9% had PDC ≥80%, 40% to 79%, and <40%. Crude incidence of CVD events were 40.1 (95% CI, 40.0–40.1), 93.9 (93.8–93.9), and 98.1 (98.1–98.2) per 1000 person‐years for PDC ≥80%, 40% to 79%, and <40%, respectively. Adjusted hazard ratios for CVD events were 1.0 (<40% as reference), 1.0 (0.97–1.03) for 40% to 79%, and 0.44 (0.42–0.45) for ≥80% (P<0.001). Dose‐response analysis suggested a nonlinear relationship between PDC and risk for CVD events with a protective effect of ≥80%. The pattern of associations between PDC and ischemic heart disease, stroke/transient ischemic attack, and heart failure were largely consistent as for CVD events and across different groups.ConclusionsAntihypertensive adherence was associated with a significantly lower risk of CVD events among older adults. There appeared to be a threshold effect in reducing CVD events at around PDC 80%, above which the risk for CVD reduced substantially.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Antihypertensive Medication Adherence and Risk of Cardiovascular Disease Among Older Adults: A Population‐Based Cohort Study

Yang

Chang

Ritchey

et al. 2017

JAHA

View full text Add to dashboard Cite

show abstract

“…In the 2000 years since, it remains unclear how much progress has been made. Research shows that medication nonadherence remains highly prevalent and is associated with adverse outcomes and higher costs of care 2, 3. For example, a year after sustaining an acute myocardial infarction, less than 50% of patients are filling prescriptions for statin, beta‐blocker, and angiotensin‐converting‐enzyme inhibitor medications, even when these medications are offered with no copay 4.…”

mentioning

confidence: 99%

“…One of the common features of successful interventions has been regular follow‐up with healthcare providers, often through focused heart failure disease management clinics 3. Given the burden of medication initiation with new and worsening heart failure and issues with polypharmacy, transitions from hospital‐to‐home after a hospital admission for heart failure decompensation are particularly vulnerable periods for patients.…”

mentioning

confidence: 99%