Exploring factors associated with patients’ adherence to antihypertensive drugs among people with primary hypertension in the United Kingdom

Amanj I Kurdi, Li-Chia Chen, Rachel A Elliott

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

ObjectiveTo explore factors associated with adherence to antihypertensive drugs overall (“therapy adherence”) and to particular classes (“class adherence”) in hypertensive patients. MethodsThis retrospective cohort study included adults with primary hypertension identified in the UK Clinical Practice Research Datalink from April/2006 to March/2013. Individuals were followed from the date of first-ever antihypertensive drug class (class adherence) prescribed and from the date of the first-ever antihypertensive drug (therapy adherence) issued to the earliest of study end, patient leaving the database or death. Prescribing episodes (time from a drug class being first prescribed to the end of follow-up time) of six antihypertensive drug classes were recorded. Proportion of Days Covered (PDC) was used to estimate therapeutic adherence for a patient’s antihypertensive drugs therapy during follow-up period and class adherence of a specific antihypertensive class in each episode, respectively. Generalized linear modelling was used to examine factors associated with PDC.ResultsMedian therapy and class PDC were 93.9% and 98.3% in the 176,835 patients and 371,605 prescribing episodes; 20% and 38.4% of the patients and episodes had PDC<80%, respectively. Higher therapy and class PDC was associated with increasing age, using renin angiotensin drugs and being pre-existing patient and user of antihypertensive drugs. Higher deprivation, multiple comorbidities and switching of antihypertensive drugs were associated with lower PDC.ConclusionsSeveral patient factors were confirmed as determinant of adherence to antihypertensive drug classes and therapy; hence they can assist in identifying patients at risks of non-adherence; thus targeting them for adherence improving interventions.
LanguageEnglish
Pages1881–1890
JournalJournal of Hypertension
Volume35
Issue number9
Early online date22 Apr 2017
DOIs
Publication statusPublished - 30 Sep 2017

Fingerprint

Patient Compliance
Antihypertensive Agents
Hypertension
Drug Therapy
United Kingdom
Angiotensins
Renin
Pharmaceutical Preparations
Comorbidity
Cohort Studies
Therapeutics
Retrospective Studies
Databases
Research

Keywords

  • adherence
  • antihypertensive drugs
  • Clinical Practice Research Datalink
  • generalized linear model
  • therapy adherence
  • class adherence
  • patient factors

Cite this

@article{15e71ce1a4bd4dc69b34673cc257e27e,
title = "Exploring factors associated with patients’ adherence to antihypertensive drugs among people with primary hypertension in the United Kingdom",
abstract = "ObjectiveTo explore factors associated with adherence to antihypertensive drugs overall (“therapy adherence”) and to particular classes (“class adherence”) in hypertensive patients. MethodsThis retrospective cohort study included adults with primary hypertension identified in the UK Clinical Practice Research Datalink from April/2006 to March/2013. Individuals were followed from the date of first-ever antihypertensive drug class (class adherence) prescribed and from the date of the first-ever antihypertensive drug (therapy adherence) issued to the earliest of study end, patient leaving the database or death. Prescribing episodes (time from a drug class being first prescribed to the end of follow-up time) of six antihypertensive drug classes were recorded. Proportion of Days Covered (PDC) was used to estimate therapeutic adherence for a patient’s antihypertensive drugs therapy during follow-up period and class adherence of a specific antihypertensive class in each episode, respectively. Generalized linear modelling was used to examine factors associated with PDC.ResultsMedian therapy and class PDC were 93.9{\%} and 98.3{\%} in the 176,835 patients and 371,605 prescribing episodes; 20{\%} and 38.4{\%} of the patients and episodes had PDC<80{\%}, respectively. Higher therapy and class PDC was associated with increasing age, using renin angiotensin drugs and being pre-existing patient and user of antihypertensive drugs. Higher deprivation, multiple comorbidities and switching of antihypertensive drugs were associated with lower PDC.ConclusionsSeveral patient factors were confirmed as determinant of adherence to antihypertensive drug classes and therapy; hence they can assist in identifying patients at risks of non-adherence; thus targeting them for adherence improving interventions.",
keywords = "adherence, antihypertensive drugs, Clinical Practice Research Datalink, generalized linear model, therapy adherence, class adherence, patient factors",
author = "Kurdi, {Amanj I} and Li-Chia Chen and Elliott, {Rachel A}",
note = "This is a non-final version of an article published in final form in Journal of Hypertension at https://doi.org/10.1097/HJH.0000000000001382",
year = "2017",
month = "9",
day = "30",
doi = "10.1097/HJH.0000000000001382",
language = "English",
volume = "35",
pages = "1881–1890",
journal = "Journal of Hypertension",
issn = "0263-6352",
publisher = "Lippincott Williams and Wilkins",
number = "9",

}

Exploring factors associated with patients’ adherence to antihypertensive drugs among people with primary hypertension in the United Kingdom. / Kurdi, Amanj I; Chen, Li-Chia; Elliott, Rachel A.

In: Journal of Hypertension, Vol. 35, No. 9, 30.09.2017, p. 1881–1890.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Exploring factors associated with patients’ adherence to antihypertensive drugs among people with primary hypertension in the United Kingdom

AU - Kurdi, Amanj I

AU - Chen, Li-Chia

AU - Elliott, Rachel A

N1 - This is a non-final version of an article published in final form in Journal of Hypertension at https://doi.org/10.1097/HJH.0000000000001382

PY - 2017/9/30

Y1 - 2017/9/30

N2 - ObjectiveTo explore factors associated with adherence to antihypertensive drugs overall (“therapy adherence”) and to particular classes (“class adherence”) in hypertensive patients. MethodsThis retrospective cohort study included adults with primary hypertension identified in the UK Clinical Practice Research Datalink from April/2006 to March/2013. Individuals were followed from the date of first-ever antihypertensive drug class (class adherence) prescribed and from the date of the first-ever antihypertensive drug (therapy adherence) issued to the earliest of study end, patient leaving the database or death. Prescribing episodes (time from a drug class being first prescribed to the end of follow-up time) of six antihypertensive drug classes were recorded. Proportion of Days Covered (PDC) was used to estimate therapeutic adherence for a patient’s antihypertensive drugs therapy during follow-up period and class adherence of a specific antihypertensive class in each episode, respectively. Generalized linear modelling was used to examine factors associated with PDC.ResultsMedian therapy and class PDC were 93.9% and 98.3% in the 176,835 patients and 371,605 prescribing episodes; 20% and 38.4% of the patients and episodes had PDC<80%, respectively. Higher therapy and class PDC was associated with increasing age, using renin angiotensin drugs and being pre-existing patient and user of antihypertensive drugs. Higher deprivation, multiple comorbidities and switching of antihypertensive drugs were associated with lower PDC.ConclusionsSeveral patient factors were confirmed as determinant of adherence to antihypertensive drug classes and therapy; hence they can assist in identifying patients at risks of non-adherence; thus targeting them for adherence improving interventions.

AB - ObjectiveTo explore factors associated with adherence to antihypertensive drugs overall (“therapy adherence”) and to particular classes (“class adherence”) in hypertensive patients. MethodsThis retrospective cohort study included adults with primary hypertension identified in the UK Clinical Practice Research Datalink from April/2006 to March/2013. Individuals were followed from the date of first-ever antihypertensive drug class (class adherence) prescribed and from the date of the first-ever antihypertensive drug (therapy adherence) issued to the earliest of study end, patient leaving the database or death. Prescribing episodes (time from a drug class being first prescribed to the end of follow-up time) of six antihypertensive drug classes were recorded. Proportion of Days Covered (PDC) was used to estimate therapeutic adherence for a patient’s antihypertensive drugs therapy during follow-up period and class adherence of a specific antihypertensive class in each episode, respectively. Generalized linear modelling was used to examine factors associated with PDC.ResultsMedian therapy and class PDC were 93.9% and 98.3% in the 176,835 patients and 371,605 prescribing episodes; 20% and 38.4% of the patients and episodes had PDC<80%, respectively. Higher therapy and class PDC was associated with increasing age, using renin angiotensin drugs and being pre-existing patient and user of antihypertensive drugs. Higher deprivation, multiple comorbidities and switching of antihypertensive drugs were associated with lower PDC.ConclusionsSeveral patient factors were confirmed as determinant of adherence to antihypertensive drug classes and therapy; hence they can assist in identifying patients at risks of non-adherence; thus targeting them for adherence improving interventions.

KW - adherence

KW - antihypertensive drugs

KW - Clinical Practice Research Datalink

KW - generalized linear model

KW - therapy adherence

KW - class adherence

KW - patient factors

UR - http://journals.lww.com/jhypertension/Abstract/2017/09000/Exploring_factors_associated_with_patients_.22.aspx

U2 - 10.1097/HJH.0000000000001382

DO - 10.1097/HJH.0000000000001382

M3 - Article

VL - 35

SP - 1881

EP - 1890

JO - Journal of Hypertension

T2 - Journal of Hypertension

JF - Journal of Hypertension

SN - 0263-6352

IS - 9

ER -