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KMID : 0191120150300121800
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Journal of Korean Medical Science
2015 Volume.30 No. 12 p.1800 ~ p.1806
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Persistence with Antihypertensive Medications in Uncomplicated Treatment-Naive Patients: Effects of Initial Therapeutic Classes
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Ah Young-Mi
Lee Ju-Yeun
Choi Yun-Jung
Kim Bae-geum
Choi Kyung-Hee
Kong Ji-sun
Oh Jung-Mi
Shin Wan-Gyoon
Lee Hae-Young
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Abstract
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We aimed to assess one-year persistence with antihypertensive therapy (AHT) among newly treated uncomplicated hypertensive patients in Korea and to evaluate the effect of initial therapeutic classes on persistence. We retrospectively analyzed a random sample of 20% of newly treated uncomplicated hypertensive patients (n = 45,787) in 2012 from the National Health Insurance claims database. This group was classified into six cohorts based on initial AHT class. We then measured treatment persistence, allowing a prescription gap of 60 days. Adherence to AHT was assessed with the medication possession ratio. Calcium channel blockers (CCB, 43.7%) and angiotensin receptor blockers (ARB, 40.3%) were most commonly prescribed as initial monotherapy. Overall, 62.1% and 42.0% were persistent with any AHT and initial class at one year, respectively, and 64.2% were adherent to antihypertensive treatment. Compared with ARBs, the risk of AHT discontinuation was significantly increased with initial use of thiazide diuretics (hazard ratio [HR], 3.16; 95% confidence interval [CI] 2.96-3.74) and beta blockers (HR, 1.86; CI, 1.77-1.95) and was minimally increased with CCBs (HR, 1.12; CI, 1.08-1.15). In conclusion, persistence and adherence to AHT are suboptimal, but the differences are meaningful in persistence and adherence between initial AHT classes.
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KEYWORD
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Uncomplicated Hypertension, Persistence, Adherence, Therapeutic Class
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