title: Does synchronizing initiation of therapy affect adherence to concomitant use of antihypertensive and lipid-lowering therapy?
abstract: Although efficacious medications are available to treat hypertension and dyslipidemia, treatment adherence is often poor. This retrospective study evaluated adherence in patients newly initiating antihypertensive (AH) and lipid-lowering (LL) therapies simultaneously versus within 180 days of one another. Data were analyzed for US managed care plan enrollees initiating AH before LL (cohort 1;n = 7099), LL before AH (cohort 2; n = 3229), or AH/LL simultaneously (cohort 3; n = 5072). A multivariate model evaluated potential predictors of adherence (medication possession ratio >or= 0.80 over a bimonthly period). Percentages of patients adherent to AH/LL at 2, 6, and 12 months were as follows: 59.4%, 32.7%, and 31.3% in cohort 1; 45.0%, 30.8%, and 31.0% in cohort 2; and 75.2%, 34.4%, and 34.0% in cohort 3, respectively. After adjustment for potential confounders, patients initiating AH before LL therapy, or LL before AH therapy, were less likely to be adherent than patients prescribed both agents simultaneously (odds ratios = 0.838 and 0.691, respectively; P , 0.0001). Synchronous initiation of AH and LL therapies is an important predictor of adherence.
authors.affiliation: Wolters Kluwer Health, Phoenix, AZ, USA. shuchag@hotmail.com
authors.forename: Shuchita
authors.initials: S
authors.lastname: Agarwal
authors.forename: Simon S K
authors.initials: SS
authors.lastname: Tang
authors.forename: Noah
authors.initials: N
authors.lastname: Rosenberg
authors.forename: Dan
authors.initials: D
authors.lastname: Pettitt
authors.forename: Trent
authors.initials: T
authors.lastname: McLaughlin
authors.forename: Amie
authors.initials: A
authors.lastname: Joyce
authors.forename: J Sanford
authors.initials: JS
authors.lastname: Schwartz
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D015331:Cohort Studies; D016208:Databases, Factual; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy; D006973:Hypertension / Q000188:drug therapy; D000960:Hypolipidemic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008329:Managed Care Programs / Q000706:statistics & numerical data; D055118:Medication Adherence; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D014481:United States
chemical_list: D000959:Antihypertensive Agents; D000960:Hypolipidemic Agents