title: Discontinuation of and changes in treatment after start of new courses of antihypertensive drugs: a study of a United Kingdom population.
abstract: OBJECTIVE
  To evaluate the incidence of discontinuation of and changes in treatment after newly prescribed courses of antihypertensive drugs of the four primary therapeutic classes: beta blocker, calcium channel blocker, and angiotensin converting enzyme inhibitor.
  
  
  METHODS
  A retrospective analysis of patients on an automated database of 1.2 million patients was conducted on visits between 1 October 1992 and 30 September 1993.
  
  
  METHODS
  General practices in the United Kingdom.
  
  
  METHODS
  37,643 patients with hypertension receiving a relevant drug in the time period were identified. A new course of treatment in at least one of the four therapeutic classes, defined as a drug not prescribed in the previous four months, was observed in 10,222 patients aged > or = 40 years.
  
  
  METHODS
  Patients changing to other treatment or discontinuing after initiating a new course of treatment, defined as the absence of a refill prescription for the new drug or another in its category within a six month observation period.
  
  
  RESULTS
  Changes in or discontinuation of treatment were frequently observed, and by month six continuation rates ranged between 40% to 50% for all four classes of drugs.
  
  
  CONCLUSIONS
  Low rates of continuation with a newly prescribed antihypertensive drug exist regardless of which drug is prescribed.
authors.affiliation: The Degge Group, Arlington VA 22209, USA.
authors.forename: J K
authors.initials: JK
authors.lastname: Jones
authors.forename: L
authors.initials: L
authors.lastname: Gorkin
authors.forename: J F
authors.initials: JF
authors.lastname: Lian
authors.forename: J A
authors.initials: JA
authors.lastname: Staffa
authors.forename: A P
authors.initials: AP
authors.lastname: Fletcher
mesh_terms: D000293:Adolescent; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003266:Continuity of Patient Care; D004232:Diuretics / Q000627:therapeutic use*; D004363:Drug Utilization; D005194:Family Practice; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D012189:Retrospective Studies
chemical_list: D000317:Adrenergic alpha-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D004232:Diuretics