title: Temporal trends in adherence to cardiovascular medications in elderly patients after hospitalization for heart failure.
abstract: Although the complexity of treatment regimens for patients with heart failure (HF) has increased over time because of the increased availability of efficacious medications, little is known about temporal trends in adherence to treatment regimens in these patients. We assessed trends in adherence to angiotensin-system blockers (ABs), β-blockers (BBs), and spironolactone (SL) for HF in Medicare beneficiaries enrolled in two statewide pharmacy benefit programs from 1995 to 2004. The proportion of days covered (PDC) (%) was assessed after the first dispensing among users of an AB, BB, or SL. Proportions of full adherence (PDC >80%) did not change over time for ABs (54% in both 1996 and 2003) but increased slightly for BBs (from 47% in 1996 to 57% in 2003) and SL (from 31% in 1996 to 42% in 2003). Black race and dialysis treatment predicted poor adherence to any medications. Adherence to BBs and SL increased modestly over time, but overall nonadherence remained high.
authors.affiliation: Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. ssetoguchi@partners.org
authors.forename: S
authors.initials: S
authors.lastname: Setoguchi
authors.forename: N K
authors.initials: NK
authors.lastname: Choudhry
authors.forename: R
authors.initials: R
authors.lastname: Levin
authors.forename: W H
authors.initials: WH
authors.lastname: Shrank
authors.forename: W C
authors.initials: WC
authors.lastname: Winkelmayer
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013148:Spironolactone / Q000627:therapeutic use; D013997:Time Factors; D016903:Drug Monitoring
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002317:Cardiovascular Agents; D013148:Spironolactone