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Persistence with antihypertensive treatments: results of a 3-year follow-up cohort study

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Objective

Effective treatment of hypertension requires continued prescribing of antihypertensive medications for many years. Persistence in prescribing habits, however, has been reported to be low. The study described herein – which is completely independent of pharmaceutical sponsors – was undertaken to evaluate persistence with antihypertensive treatment in Germany.

Methods

A total of 13,763 newly diagnosed hypertensive patients were identified in the IMS Disease Analyzer database and observed for 3 years after their first antihypertensive prescription.

Results

The median age of the study cohort was 65 years, and 56% were female. One in four patient received no more than three prescriptions within 3 years. Persistence was longest for patients whose initial prescription was for a free combination based on angiotensin converting enzyme inhibitors (median: 392.5 days), followed patients initially receiving a fixed combination, including angiotensin II receptor antagonists (208.5 days) and AIIRA monotherapy (168 days). Persistence was shortest with diuretics (57 days). Across all treatment groups, persistence after 3 years was 15.2%. Insurance status, sex and comorbidities were not found to impact persistence.

Conclusion

Our data indicate that persistence differs markedly among the drug classes (p ≤ 0.001) but that even persistence of the best drug class is not sufficient to provide for an adequate blood pressure control in the population. The largest decline in persistence occurred in the first 3 months of treatment. More research is needed to elucidate the causes of this early drop in persistence and to develop effective means of improving the currently unsatisfactory situation.

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Authors and Affiliations

  1. IBE – Department of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, Munich, Germany

    Joerg Hasford & Marietta Rottenkolber

  2. IMS HEALTH GmbH & Co. OHG, Hahnstrasse 30-32, 60528, Frankfurt, Germany

    Detlef Schröder-Bernhardi, Karel Kostev & Gerhard Dietlein

Authors
  1. Joerg Hasford
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  2. Detlef Schröder-Bernhardi
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  3. Marietta Rottenkolber
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  4. Karel Kostev
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  5. Gerhard Dietlein
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Correspondence to Joerg Hasford.

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Hasford, J., Schröder-Bernhardi, D., Rottenkolber, M. et al. Persistence with antihypertensive treatments: results of a 3-year follow-up cohort study. Eur J Clin Pharmacol 63, 1055–1061 (2007). https://doi.org/10.1007/s00228-007-0340-2

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  • DOI: https://doi.org/10.1007/s00228-007-0340-2

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