Korean Circ J.  2016 May;46(3):384-393. 10.4070/kcj.2016.46.3.384.

Medication Adherence and the Occurrence of Complications in Patients with Newly Diagnosed Hypertension

Affiliations
  • 1Department of Rehabilitation Standard & Policy, Korea National Rehabilitation Research Institute, Seoul, Korea.
  • 2Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea. yoonsj02@korea.ac.kr
  • 3Department of Preventive Medicine, Kyung Hee University College of Medicine, Seoul, Korea.
  • 4Cancer Policy Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea.

Abstract

BACKGROUND AND OBJECTIVES
In this retrospective cohort study, we sought to elucidate the relationship between medication adherence (MA) and the incidence of complications in patients with newly diagnosed hypertension.
SUBJECTS AND METHODS
Using claims data from the National Health Insurance Service, we measured health outcomes based on levels of MA, analyzed the incidence of complications in patients with a good MA, and clarified factors that may affect or predict MA.
RESULTS
In 2008, a total of 4294773 patients were diagnosed with hypertension and were subsequently prescribed anti-hypertensive medications. In the present study, we enrolled 564782 patients who met our inclusion/exclusion criteria. The 40-59% medication possession ratio (MPR) group had a 1.36 times higher risk of developing complications (95% confidence interval [CI]: 1.27-1.45) than did the MPR≥ 80% group, as revealed through Cox's proportional hazards analysis. Similarly, the <20% MPR group was 2.01 times more likely to develop complications than the good MA group (95% CI: 1.82-2.23). Overall, patients who had a lower level of MA had a higher risk of developing complications.
CONCLUSION
Our results demonstrate that MA is tightly correlated with hypertension health outcomes. Improving MA could be one strategy for reducing the risk of cerebrovascular disease complications and the loss of productivity in these patients.

Keyword

Hypertension; Medication adherence; Anti-hypertensive medications; Cerebrovascular disease

MeSH Terms

Cerebrovascular Disorders
Cohort Studies
Efficiency
Humans
Hypertension*
Incidence
Medication Adherence*
National Health Programs
Retrospective Studies

Figure

  • Fig. 1 Study population dataset for continuity of care.


Cited by  2 articles

Lifestyle Modification, the Effective but Neglected Strategy in Lowering Blood Pressure
Wook Bum Pyun
Korean Circ J. 2018;48(7):652-654.    doi: 10.4070/kcj.2018.0194.

Improving the Quality of Hypertension Management: Multifaceted Approach
Mi-Hyang Jung, Sang-Hyun Ihm
Korean Circ J. 2019;49(6):528-531.    doi: 10.4070/kcj.2019.0055.


Reference

1. Cade WT. Diabetes-related microvascular and macrovascular diseases in the physical therapy setting. Phys Ther. 2008; 88:1322–1335.
2. Kim HJ, Kim YA, Seo HY, Kim EJ, Yoon SJ, Oh IH. The economic burden of stroke in 2010 in Korea. J Korean Med Assoc. 2012; 55:1226–1236.
3. Heidenreich PA, Trogdon JG, Khavjou OA, et al. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American heart association. Circulation. 2011; 123:933–944.
4. Kang JH, Jeong BG, Cho YG, Song HR, Kim KA. Socioeconomic costs of overweight and obesity in Korean adults. J Korean Med Sci. 2011; 26:1533–1540.
5. Brown MT, Bussell JK. Medication adherence: WHO cares? Mayo Clin Proc. 2011; 86:304–314.
6. Dreiher J, Comaneshter DS, Rosenbluth Y, Battat E, Bitterman H, Cohen AD. The association between continuity of care in the community and health outcomes: a population-based study. Isr J Health Policy Res. 2012; 1:21.
7. Vlasnik JJ, Aliotta SL, DeLor B. Medication adherence: factors influencing compliance with prescribed medication plans. Case Manager. 2005; 16:47–51.
8. Staessen JA, Wang JG, Thijs L. Cardiovascular protection and blood pressure reduction: a meta-analysis. Lancet. 2001; 358:1305–1315.
9. Jin J, Sklar GE, Min Sen Oh V, Chuen Li S. Factors affecting therapeutic compliance: a review from the patient's perspective. Ther Clin Risk Manag. 2008; 4:269–286.
10. Muszbek N, Brixner D, Benedict A, Keskinaslan A, Khan ZM. The economic consequences of noncompliance in cardiovascular disease and related conditions: a literature review. Int J Clin Pract. 2008; 62:338–351.
11. Kang HY, Yang KH, Kim YN, et al. Incidence and mortality of hip fracture among the elderly population in South Korea: a population-based study using the national health insurance claims data. BMC Public Health. 2010; 10:230.
12. Oh IH, Yoon SJ, Seo HY, Kim EJ, Kim YA. The economic burden of musculoskeletal disease in Korea: a cross sectional study. BMC Musculoskelet Disord. 2011; 12:157.
13. Sokol MC, McGuigan KA, Verbrugge RR, Epstein RS. Impact of medication adherence on hospitalization risk and healthcare cost. Med Care. 2005; 43:521–530.
14. Skaer TL, Sclar DA, Robison LM, Markowski DJ, Won JK. Effect of pharmaceutical formulation for diltiazem on health care expenditures for hypertension. Clin Ther. 1993; 15:905–911.
15. Washington DL, Harada ND, Villa VM, et al. Racial variations in Department of Veterans Affairs ambulatory care use and unmet health care needs. Mil Med. 2002; 167:235–241.
16. Hodgson TA, Cai L. Medical care expenditures for hypertension, its complications, and its comorbidities. Med Care. 2001; 39:599–615.
17. Friedman O, McAlister FA, Yun L, Campbell NR, Tu K; Canadian Hypertension Education Program Outcomes Research Taskforce. Antihypertensive drug persistence and compliance among newly treated elderly hypertensives in Ontario. Am J Med. 2010; 123:173–181.
18. Lee CY, Huang CC, Shih HC, Huang KH. Factors influencing antihypertensive medication compliance in Taiwan: a nationwide population-based study. Eur J Prev Cardiol. 2013; 20:930–937.
19. Lee DH, Choi YH, Lee KH, et al. Factors associated with hypertension control and antihypertensive medication among hypertensive patients in a community. Korean J Prev Med. 2003; 36:289–297.
20. Ren XS, Kazis LE, Lee A, Zhang H, Miller DR. Identifying patient and physician characteristics that affect compliance with antihypertensive medications. J Clin Pharm Ther. 2002; 27:47–56.
21. Patel RP, Taylor SD. Factors affecting medication adherence in hypertensive patients. Ann Pharmacother. 2002; 36:40–45.
22. Sax PE, Meyers JL, Mugavero M, Davis KL. Adherence to antiretroviral treatment and correlation with risk of hospitalization among commercially insured HIV patients in the United States. PLoS One. 2012; 7:e31591.
23. Knight EL, Bohn RL, Wang PS, Glynn RJ, Mogun H, Avorn J. Predictors of uncontrolled hypertension in ambulatory patients. Hypertension. 2001; 38:809–814.
24. Ruger JP, Kim HJ. Out-of-pocket healthcare spending by the poor and chronically ill in the Republic of Korea. Am J Public Health. 2007; 97:804–811.
25. Briesacher BA, Gurwitz JH, Soumerai SB. Patients at-risk for cost-related medication nonadherence: a review of the literature. J Gen Intern Med. 2007; 22:864–871.
26. Wald DS, Law M, Morris JK, Bestwick JP, Wald NJ. Combination therapy versus monotherapy in reducing blood pressure: meta-analysis on 11,000 participants from 42 trials. Am J Med. 2009; 122:290–300.
27. Dragomir A, Côté R, Roy L, et al. Impact of adherence to antihypertensive agents on clinical outcomes and hospitalization costs. Med Care. 2010; 48:418–425.
28. Ademi Z, Huq MM, Liew D, et al. The impact of lost therapeutic benefit (LTB) in high-risk hypertensive patients: 2-year follow-up data from the Australian REACH registry. Cardiovasc Ther. 2013; 31:370–376.
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