Non-persistence and low adherence are common among younger adults initiating anti-hypertensive medications and have not improved over time, investigators in a study published in the most recent issue of Hypertension have explained.
Gabriel S. Tajeu, Dr.P.H., M.P.H., from Temple University in Philadelphia, and colleagues examined trends in anti-hypertensive medication non-persistence and low adherence among 379,658 commercially insured adults aged <65 years initiating treatment in 2007 to 2014.
The researchers found that 23.3 and 23.5 percent of patients were non-persistent with treatment in 2007 and 2014, respectively, and 42.3 and 40.2 percent had low adherence. Lower relative risks of non-persistence and low adherence were seen for beneficiaries initiating treatment with an angiotensin-converting enzyme inhibitor (0.95 [95 percent confidence interval (CI), 0.94 to 0.97] and 0.97 [95 percent CI, 0.96 to 0.98], respectively), angiotensin receptor blocker (0.86 [95 percent CI, 0.85 to 0.88] and 0.99 [95 percent CI, 0.97 to 1.00], respectively), or multiclass regimen (0.82 [95 percent CI, 0.80 to 0.84] and 0.88 [95 percent CI, 0.86 to 0.89], respectively); relative risks were also lower with prescribed 90-day versus 30-day prescriptions (0.67 [95 percent CI, 0.66 to 0.68] and 0.70 [95 percent CI, 0.69 to 0.71], respectively) and for those receiving medications by mail versus at the pharmacy (0.93 [95 percent CI, 0.90 to 0.95] and 0.90 [95 percent CI, 0.88 to 0.92], respectively).
“The current analyses suggest some possible approaches to improving adherence,” the authors wrote.
“Given their association with lower rates of non-persistence and low adherence, 90-day and mail order prescriptions should be promoted, and randomized controlled trials should be conducted to determine the impact of these scalable interventions on anti-hypertensive medication adherence.”
REFERENCE: Tajeu et al: Antihypertensive Medication Non-persistence and Low Adherence for Adults <65 Years Initiating Treatment in 2007–2014; https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.118.12495