Impact of Adherence to Antihypertensive Agents on Clinical Outcomes and Hospitalization Costs

Datos Bibliográficos

ID9101909
AutoresAlice Dragomir (0000-0003-3858-3777, Université de Montréal, autor de correspondencia), Rochelle Côté (0000-0002-0188-507X, McGill University), Robert Côté, Louise Roy (0000-0003-4507-919X, Université de Montréal), Lucie Blais (0000-0001-8420-3128, Université de Montréal, autor de correspondencia), Lyne Lalonde (Université de Montréal, autor de correspondencia), Anick Berard (0000-0001-7535-5517, Université de Montréal, autor de correspondencia), Sylvie Perreault (0000-0002-0066-0127, Université de Montréal, autor de correspondencia)
Año2010
Volumen48
Número5
Páginas418-425
Fecha de publicación2010-05-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e3181d567bd
PMID20393367
OpenAlexW1966704625
IdiomaEN
Citas recibidas10
Referencias citadas34

BACKGROUND: Cardiovascular diseases (CVD) represent a heavy economic burden on individuals, health services, and society. Low adherence to antihypertensive (AH) agents is acknowledged as a major contributor to the lack of blood pressure control, and may have a significant impact on clinical outcomes and healthcare costs. OBJECTIVES: To evaluate the impact of low adherence to AH agents on cardiovascular outcomes and hospitalization costs. METHODS: A cohort of 59,647 patients with essential hypertension was reconstructed from the Régie de l'assurance maladie du Québec and Med-Echo databases. Subjects included were between 45 and 85 years of age, without any evidence for symptomatic CVD, newly treated with AH agents between 1999 and 2002 and followed-up for a 3-year period. Adherence to AH agents was categorized as >or=80% or <80%. The adjusted odds ratio (OR) for CVD events between the 2 adherence groups was estimated using a polytomous logistic analysis. A 2-part model was applied for hospitalization costs. RESULTS: Patients with low adherence were more likely to have coronary disease (OR, 1.07; 95% confidence interval [CI], 1.00-1.13), cerebrovascular disease (OR, 1.13; 95% CI, 1.03-1.25), and chronic heart failure (OR, 1.42; 95% CI, 1.27-1.58) within the 3-year follow-up period. Among hospitalized patients, low adherence to AH therapy was associated with increased costs by approximately $3574 (95% CI, $2897-$4249) per person within a 3-year period. CONCLUSIONS: Low adherence to AH agents is correlated with a higher risk of vascular events, hospitalization, and greater healthcare costs. An increased level of adherence to AH agents should provide a better health status for individuals and a net economic gain

Blood pressure · Cohort · Confidence interval · Depression (economics) · Disease · Intensive care medicine · Odds ratio · Blood Pressure and Hypertension Studies · Emergency Medicine · Heart Failure Treatment and Management · Internal Medicine · Medication Adherence and Compliance · Medicine