Author + information
- Huifeng Yun,
- Elizabeth Delzell,
- Emily Levitan,
- Pradeep Sharma,
- Monika Safford,
- Vera Bittner,
- Todd Brown,
- John Booth III,
- Meredith Kilgore,
- Michael Farkouh,
- Suma Vupputuri,
- Robert Rosenson and
- Paul Muntner
Patients not adherent to one drug class may be more likely to discontinue a newly prescribed therapy. We sought to determine if the level of adherence to antihypertensive medication prior to initiating statin therapy is associated with statin discontinuation.
Using a 5% national random sample of Medicare beneficiaries enrolled in traditional fee-for-service Medicare with prescription drug coverage in 2007, we identified new users of statins defined by filling ≥1 statin prescription in 2007 without a statin prescription in the previous 365 days (the “baseline” period). Statin discontinuation was defined as failure to renew statins within 1 year of initiating treatment with no subsequent fills for 365 days. Antihypertensive medication adherence was assessed by computing medication possession ratios (MPR) for diuretics, calcium channel blockers, angiotensin receptor blockers, angiotensin converting enzyme inhibitors, and beta blockers at baseline.
Of 25,308 new statin users, 18,434 (72.8%) took antihypertensive drugs during the baseline period. Of beneficiaries taking antihypertensive medications, 61.2%, 25.8% and 13.0% had an MPR of ≥ 80%, 50% to <80% and < 50%, respectively. Lower adherence to antihypertensive medications was associated with an increased hazard ratio for statin discontinuation. (Table)
Low adherence to antihypertensive medication may be useful in identifying patients likely to discontinue statins within one year of initiation.
|Medication Possession Ratio for antihypertensive drugs during baseline†|
|≥ 80%||50 to < 80%||< 50%|
|New statin users||11,277||4,748||2,409|
|% discontinuing statins within 1 year||19.6%||23.5%||26.3%|
|Hazard ratio*(95% confidence interval)||1 (Ref)||1.21 (1.13 – 1.30)||1.38 (1.26 – 1.51)|
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Coronary Risk Factors and Management
Abstract Category: 28. Quality of Care and Outcomes Assessment
Presentation Number: 1115-100
- 2013 American College of Cardiology Foundation