Does synchronizing initiation of therapy affect adherence to concomitant use of antihypertensive and lipid-lowering therapy?
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.
Agarwal
Shuchita
S
Wolters Kluwer Health, Phoenix, AZ, USA. shuchag@hotmail.com
Tang
Simon S K
SS
Rosenberg
Noah
N
Pettitt
Dan
D
McLaughlin
Trent
T
Joyce
Amie
A
Schwartz
J Sanford
JS
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
D000959:Antihypertensive Agents; D000960:Hypolipidemic Agents