title: Persistence with Antihypertensive Medications in Uncomplicated Treatment-Naïve Patients: Effects of Initial Therapeutic Classes.
abstract: We aimed to assess one-year persistence with antihypertensive therapy (AHT) among newly treated uncomplicated hypertensive patients in Korea and to evaluate the effect of initial therapeutic classes on persistence. We retrospectively analyzed a random sample of 20% of newly treated uncomplicated hypertensive patients (n = 45,787) in 2012 from the National Health Insurance claims database. This group was classified into six cohorts based on initial AHT class. We then measured treatment persistence, allowing a prescription gap of 60 days. Adherence to AHT was assessed with the medication possession ratio. Calcium channel blockers (CCB, 43.7%) and angiotensin receptor blockers (ARB, 40.3%) were most commonly prescribed as initial monotherapy. Overall, 62.1% and 42.0% were persistent with any AHT and initial class at one year, respectively, and 64.2% were adherent to antihypertensive treatment. Compared with ARBs, the risk of AHT discontinuation was significantly increased with initial use of thiazide diuretics (hazard ratio [HR], 3.16; 95% confidence interval [CI] 2.96-3.74) and beta blockers (HR, 1.86; CI, 1.77-1.95) and was minimally increased with CCBs (HR, 1.12; CI, 1.08-1.15). In conclusion, persistence and adherence to AHT are suboptimal, but the differences are meaningful in persistence and adherence between initial AHT classes.
authors.affiliation: College of Pharmacy, Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, Korea.
authors.forename: Young-Mi
authors.identifier: 0000-0003-1607-9828
authors.initials: YM
authors.lastname: Ah
authors.affiliation: College of Pharmacy, Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, Korea.
authors.forename: Ju-Yeun
authors.identifier: 0000-0002-2261-7330
authors.initials: JY
authors.lastname: Lee
authors.affiliation: College of Pharmacy, Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, Korea.
authors.forename: Yun-Jung
authors.identifier: 0000-0002-1648-9264
authors.initials: YJ
authors.lastname: Choi
authors.affiliation: College of Pharmacy, Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, Korea.
authors.forename: Baegeum
authors.identifier: 0000-0002-0636-4548
authors.initials: B
authors.lastname: Kim
authors.affiliation: College of Pharmacy, Sunchon National University, Suncheon, Korea.
authors.forename: Kyung Hee
authors.identifier: 0000-0002-9532-1581
authors.initials: KH
authors.lastname: Choi
authors.affiliation: College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Korea.
authors.forename: Jisun
authors.identifier: 0000-0001-9061-8442
authors.initials: J
authors.lastname: Kong
authors.affiliation: College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Korea.
authors.forename: Jung Mi
authors.identifier: 0000-0002-1836-1707
authors.initials: JM
authors.lastname: Oh
authors.affiliation: College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Korea.
authors.forename: Wan Gyoon
authors.identifier: 0000-0001-9371-7040
authors.initials: WG
authors.lastname: Shin
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Hae-Young
authors.identifier: 0000-0002-9521-4102
authors.initials: HY
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000145:classification / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D056910:Republic of Korea; D012189:Retrospective Studies; D049993:Sodium Chloride Symporter Inhibitors / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D049993:Sodium Chloride Symporter Inhibitors
keywords: Adherence; Persistence; Therapeutic Class; Uncomplicated Hypertension