Determinants of discontinuation of new courses of antihypertensive medications

Discontinuation of medication use constitutes a major barrier to adequate control of high blood pressure. We examined the effect of an array of potential predisposing, enabling and reinforcing factors on the discontinuation of newly prescribed antihypertensive medications. We conducted a prospective...

Full description

Saved in:
Bibliographic Details
Published in:Journal of clinical epidemiology 2002-07, Vol.55 (7), p.728-735
Main Authors: Grégoire, Jean-Pierre, Moisan, Jocelyne, Guibert, Rémi, Ciampi, Antonio, Milot, Alain, Gaudet, Michel, Côté, Isabelle
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Antihypertensive agents
Antihypertensive Agents - adverse effects
Antihypertensive Agents - economics
Antihypertensive Agents - therapeutic use
Biological and medical sciences
Canada
Cardiovascular system
Cohort Studies
Compliance
Determinants
Discontinuation
Drug treatment
Female
Health Knowledge, Attitudes, Practice
Humans
Hypertension
Insurance, Pharmaceutical Services
Interviews as Topic
Male
Medical sciences
Middle Aged
Pharmacies
Pharmacology. Drug treatments
Proportional Hazards Models
Prospective Studies
Self Administration - psychology
Self Administration - statistics & numerical data
Treatment Refusal - psychology
Treatment Refusal - statistics & numerical data
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Discontinuation of medication use constitutes a major barrier to adequate control of high blood pressure. We examined the effect of an array of potential predisposing, enabling and reinforcing factors on the discontinuation of newly prescribed antihypertensive medications. We conducted a prospective cohort study through a network of 173 pharmacies across Canada where were identified individuals newly prescribed an antihypertensive monotherapy. We interviewed participants by telephone four times to obtain information for a minimum duration of 18 months after entry into the cohort. We analyzed data using a multivariate proportional hazard model. Of 682 eligible participants, 43.3% had discontinued their initial medication at the end of the observation period. Individuals more likely to discontinue their initial medication were those who perceived side effects from this medication [Hazard Ratio (HR) = 1.91; 95% Confidence Interval (CI) 1.47–2.47). Individuals with medication insurance coverage were less likely to discontinue (HR = 0.74; 95% CI 0.55–0.99). Persistence with newly prescribed medications could be improved by selecting antihypertensive medications containing fewer side effects and by lifting economic barriers to drug treatment.
ISSN:0895-4356
1878-5921
DOI:10.1016/S0895-4356(02)00400-6