TY - JOUR
T1 - Reduced discontinuation of antihypertensive treatment by two-drug combination as first step. Evidence from daily life practice
AU - Corrao, Giovanni
AU - Parodi, Andrea
AU - Zambon, Antonella
AU - Heiman, Franca
AU - Filippi, Alessandro
AU - Cricelli, Claudio
AU - Merlino, Luca
AU - Mancia, Giuseppe
PY - 2010/7
Y1 - 2010/7
N2 - Objectives: To measure persistence with antihypertensive drug therapy in patients initiating treatment with mono or combination therapy. Methods: Data analysis was based on two cohorts of patients, that is, a cohort derived from the registration of drug prescriptions in all residents of the Lombardy region receiving Public Health Service and a cohort of patients followed by general practitioners throughout the Italian territory. Data were limited to patients aged 40-80 years who received their first antihypertensive drug prescription (n = 433680 and 41199, respectively) in whom persistency of treatment was examined over 9 months. A proportional hazards model was fitted to estimate the association between the pattern of initial antihypertensive drug therapy and risk of treatment discontinuation. Data were adjusted for available potential confounders. Results: Taking patients starting with diuretic monotherapy as reference, the adjusted risk of treatment discontinuation was progressively lower in patients starting with monotherapy other than a diuretic, a two-drug combination, including a diuretic and a two-drug combination without a diuretic. No significant difference in the risk of discontinuation was seen between extemporaneous and fixed dose combinations, including a diuretic, that is, the only combination reimbursable by Public Health Service and, thus, available in the database. Data were similar for the two cohorts. Conclusion: Initiating treatment with a combination of two drugs is associated with a reduced risk of treatment discontinuation.
AB - Objectives: To measure persistence with antihypertensive drug therapy in patients initiating treatment with mono or combination therapy. Methods: Data analysis was based on two cohorts of patients, that is, a cohort derived from the registration of drug prescriptions in all residents of the Lombardy region receiving Public Health Service and a cohort of patients followed by general practitioners throughout the Italian territory. Data were limited to patients aged 40-80 years who received their first antihypertensive drug prescription (n = 433680 and 41199, respectively) in whom persistency of treatment was examined over 9 months. A proportional hazards model was fitted to estimate the association between the pattern of initial antihypertensive drug therapy and risk of treatment discontinuation. Data were adjusted for available potential confounders. Results: Taking patients starting with diuretic monotherapy as reference, the adjusted risk of treatment discontinuation was progressively lower in patients starting with monotherapy other than a diuretic, a two-drug combination, including a diuretic and a two-drug combination without a diuretic. No significant difference in the risk of discontinuation was seen between extemporaneous and fixed dose combinations, including a diuretic, that is, the only combination reimbursable by Public Health Service and, thus, available in the database. Data were similar for the two cohorts. Conclusion: Initiating treatment with a combination of two drugs is associated with a reduced risk of treatment discontinuation.
KW - antihypertensive agents
KW - claims database
KW - defined daily dose
KW - medical records
KW - persistence
KW - treatment discontinuation
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U2 - 10.1097/HJH.0b013e328339f9fa
DO - 10.1097/HJH.0b013e328339f9fa
M3 - Article
C2 - 20543716
AN - SCOPUS:77954382755
VL - 28
SP - 1584
EP - 1590
JO - Journal of Hypertension
JF - Journal of Hypertension
SN - 0263-6352
IS - 7
ER -