Adherence to calcium channel blocker therapy in older adults: a comparison of amlodipine and felodipine.
The efficacy of dihydropyridine calcium channel blockers for treating hypertension appears to be similar, but a variety of factors, including patient characteristics, tolerability and pharmacokinetic properties, may influence treatment adherence and outcome. We aimed to evaluate treatment adherence in clinical practice among older hypertensive adults (50+ years) prescribed amlodipine or felodipine for the first time as part of the California Medicaid (Medi-Cal) program. We used a retrospective, matched, cohort-analysis design. Over 1 year, patients prescribed amlodipine were 21% less likely to discontinue study treatment than those prescribed felodipine. Discontinuation tended to occur early, with 20% and 30% of amlodipine and felodipine patients, respectively, discontinuing treatment after one prescription. A non-significant difference in favour of amlodipine was demonstrated for anti-anginal medication use among patients taking these drugs at baseline. This study suggests that use of amlodipine may be associated with improved adherence, compared with felodipine, among older out-patients in the Medi-Cal program.
Menzin
J
J
Boston Health Economics, Inc., Waltham, MA, USA. jmenzin@bhei.com
Lang
K
K
Elliott
W J
WJ
Boulanger
L
L
Arocho
R
R
Tran
M H
MH
Friedman
M
M
D000368:Aged; D000369:Aged, 80 and over; D017311:Amlodipine / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D002140:California; D015331:Cohort Studies; D015736:Felodipine / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008484:Medicaid; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies; D016896:Treatment Outcome
D002121:Calcium Channel Blockers; D017311:Amlodipine; D015736:Felodipine