Factors associated with compliance, discontinuation and switching of calcium channel blockers in 20,156 Chinese patients.
BACKGROUND
Noncompliance and nonpersistence to antihypertensive drugs is a recognized worldwide problem. Calcium channel blockers (CCBs) are commonly prescribed among Chinese patients yet few studies have been conducted to study the factors associated with their compliance, discontinuation, and switching profiles.


METHODS
From clinical databases we studied 20,156 patients prescribed a CCB as their antihypertensive monotherapy from January 2004 to June 2007 in a large Territory of Hong Kong. We evaluated their compliance by medication possession ratios (MPRs), cumulative incidences of discontinuation and switching within 180 days after the prescription; and evaluated their associated factors using multivariable logistic regression analyses.


RESULTS
The crude compliance level, discontinuation and switching rates at 180 days were 85.0, 3.1, and 5.0%, respectively. Older patients (aged > or =50 years; adjusted odds ratio (aOR) 1.21-1.34, P < 0.001), female gender (aOR 0.89, 95% confidence interval (CI) 0.82-0.96 for males, P = 0.004), fee payers (aOR 1.09, 95% CI 1.00-1.20, P = 0.050), service settings in family medicine specialist clinic (FMSC) (aOR 1.64, 95% CI 1.33-2.01, P < 0.001), and follow-up visits (aOR 3.24, 95% CI 2.93-3.58, P < 0.001) were positively associated with good compliance. Younger age and new visits were significantly associated with drug discontinuation or switching.


CONCLUSIONS
Younger patients, male subjects, and new visitors were more likely to be noncompliant to CCB among ethnic Chinese. They represent the target subjects where primary care physicians should spend more effort on patient education to improve drug compliance.
Wong
Martin C S
MC
School of Public Health and Department of Community and Family Medicine, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong.
Jiang
Johnny Y
JY
Griffiths
Sian M
SM
D000367:Age Factors; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D016208:Databases, Factual; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012737:Sex Factors; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers