Identifying patient and physician characteristics that affect compliance with antihypertensive medications.
BACKGROUND
Compliance with antihypertensive medications is essential to the clinical management of hypertension. Poor compliance with antihypertensive medications has often been associated with treatment failure and disease progression.


OBJECTIVE
To identify patient and prescriber characteristics that may influence compliance with antihypertensive medications.


METHODS
We used pharmacy records within the Veterans Health Administration, a database which included 1292 patients and 656 physicians over a 2-year time period from April 1, 1996, to April 1, 1998. The level of compliance with antihypertensive medications was assessed using a measure developed for this purpose within the Administration. Three separate ordinary least squares regression models were conducted to ascertain the effects of patient and physician characteristics on compliance.


RESULTS
Despite the importance of compliance in the clinical management of hypertension, poor compliance with antihypertensive drug treatment was still widespread. Patients who were younger and less active in their treatment decisions tended to be less compliant (P < 0.05 and 0.05, respectively). Health care providers who were older, residents in speciality care, and physicians (as compared with non-physicians) had patients who were also less likely to be compliant (P < 0.01, 0.01, and 0.05, respectively).


CONCLUSIONS
These findings suggest that in order to increase the effectiveness of medical care for hypertension, it is important to improve compliance with antihypertensive agents.
Ren
X S
XS
Health Outcomes Technologies, Health Services Department, Boston University School of Public Health, Boston, MA 02118, USA. xsren@bu.edu
Kazis
L E
LE
Lee
A
A
Zhang
H
H
Miller
D R
DR
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003657:Decision Making; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008297:Male; D008511:Medicine; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D010819:Physician's Role; D012189:Retrospective Studies; D013038:Specialization
D000959:Antihypertensive Agents