Abstract:
BACKGROUND:Diuretics are recommended as initial treatment for hypertension. Several studies have suggested suboptimal persistence and adherence to thiazide diuretic monotherapy; this study compared patient persistence and adherence with hydrochlorothiazide (HCTZ) monotherapy to fixed-dose combinations containing HCTZ. METHODS:Patients with at least one prescription claim during 2001 to 2003 for either HCTZ or one of the following fixed-dose combinations: angiotensin-receptor blockers/HCTZ (ARB/HCTZ), angiotensin-converting enzyme inhibitor/HCTZ (ACEI/HCTZ), or beta blockers/HCTZ (BB/HCTZ) were identified. Patients were required to be continuously benefit-eligible six months pre- and one year post-index date, and to have no prescription claims for any antihypertensive therapy six months prior to the index date. Patients were followed for one year to assess persistence, medication possession ratio (MPR), adherence (MPR >80%), and proportion of days covered (PDC) with initial antihypertensive therapy. Logistic regression was used to calculate adjusted odds ratios for persistence, adherence and PDC, adjusted for age, gender, business segment, RxRisk disease categories, average co-pay and concurrent cardiovascular-related medication utilization. RESULTS:The study cohort consisted of 48,212 patients; 72.5% used HCTZ, 13.2% ACEI/HCTZ, 9.3% ARB/HCTZ, and 5.0% BB/HCTZ. Mean age was 53.7 years and 66.5% were female. A significantly lower proportion of patients using HCTZ (29.9%) remained persistent with therapy at 12 months compared with ARB/HCTZ (52.6%; OR = 0.37, CI = 0.36, 0.38), ACEI/HCTZ (51.4%; OR = 0.38, CI = 0.37, 0.39), and BB/HCTZ (51.9%; OR = 0.38, 0.37, 0.40). Similarly, PDC was lower for HCTZ patients (32.5%) as compared to ARB/HCTZ (53.7%; OR = 0.39, CI = 0.37, 0.40), ACEI/HCTZ (50.9%; OR = 0.42, CI = 0.40, 0.43), and BB/HCTZ (51.3%; OR = 0.44, CI 0.42, 0.45). MPR was also significantly lower for HCTZ patients as compared to those using fixed-dose combination therapies. CONCLUSION:Initiating HCTZ fixed-dose combination therapy with an ACEI, ARB, or BB was associated with greater persistence and adherence as compared to HCTZ monotherapy. Further research is needed to determine the relationship between improved persistence and adherence with blood pressure control.
journal_name
BMC Fam Practjournal_title
BMC family practiceauthors
Patel BV,Remigio-Baker RA,Thiebaud P,Preblick R,Plauschinat Cdoi
10.1186/1471-2296-9-61subject
Has Abstractpub_date
2008-11-06 00:00:00pages
61issn
1471-2296pii
1471-2296-9-61journal_volume
9pub_type
杂志文章abstract:BACKGROUND:Due to demographic change, general practitioners (GPs) are increasingly required to care for older people with complex health problems. Little is known about the subjective appraisals of GPs concerning the demanded changes. Our objective is to explore how general practitioners view their professional mandate...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0249-2
更新日期:2015-03-14 00:00:00
abstract:BACKGROUND:The objective of this study is to perform an independent evaluation of the feasibility and effectiveness of an educational programme for the primary prevention of type 2 diabetes (DM2) in high risk populations in primary care settings, implanted within the Basque Health Service - Osakidetza. METHODS/DESIGN:...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-13-109
更新日期:2012-11-16 00:00:00
abstract:BACKGROUND:The QUALICOPC (Quality and Costs of Primary Care in Europe) study aims to evaluate the performance of primary care systems in Europe in terms of quality, equity and costs. The study will provide an answer to the question what strong primary care systems entail and which effects primary care systems have on t...
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doi:10.1186/1471-2296-12-115
更新日期:2011-10-20 00:00:00
abstract:BACKGROUND:Throat pain is a common complaint in the ambulatory setting. Diagnosis of group A Streptococcus is made with a culture, molecular test or a rapid antigen detection test from the tonsils or the posterior pharyngeal wall, while other areas of the oral cavity are considered unacceptable. The purpose of the stud...
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pub_type: 杂志文章
doi:10.1186/s12875-020-01129-6
更新日期:2020-03-26 00:00:00
abstract:BACKGROUND:Multimorbidity is a major issue for primary care. We aimed to explore primary care professionals' accounts of managing multimorbidity and its impact on clinical decision making and regional health care delivery. METHODS:Qualitative interviews with 12 General Practitioners and 4 Primary Care Nurses in New Ze...
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doi:10.1186/s12875-017-0622-4
更新日期:2017-04-05 00:00:00
abstract:BACKGROUND:Late diagnosis is considered to be a major factor contributing to poorer cancer survival rates in the UK. Interventions have focussed on the promotion of earlier diagnosis in patients with potential cancer symptoms. However, to assess the effectiveness of these interventions, the time from symptom onset to p...
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doi:10.1186/s12875-014-0167-8
更新日期:2014-10-25 00:00:00
abstract:BACKGROUND:Poorly controlled diabetes leads to multiple complications including oral health problems. General practitioners (GPs) are at the forefront of management of chronic diseases in primary health care. Diabetes guidelines encourage a proactive role for GPs in oral health complications management in people with d...
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doi:10.1186/s12875-020-1102-9
更新日期:2020-02-13 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12875-015-0291-0
更新日期:2015-06-19 00:00:00
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journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-10-49
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:There are a substantial number of instruments for primary-care clinicians to assess physical-activity (PA). However, there are few studies that have explored the views of clinicians regarding comparative acceptability and ease of use. A better understanding of how clinicians perceive instruments could help o...
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abstract:BACKGROUND:Ultrasound imaging is utilized in Swiss primary care; however, little is known regarding the extent to which it is performed. With this study, we aim to (1) provide an overview of ultrasound use by general practitioners (GPs), and (2) determine the clinical indications of ultrasound in Swiss general practice...
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abstract:BACKGROUND:Gout is estimated to affect 1.4% of adults in the UK. Appropriate and timely management is essential to reduce the risk of further flares, complications, and to reduce cardiovascular disease risk. The British Society for Rheumatology and British Health Professionals in Rheumatology (BSR/BHPR) and the Europea...
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journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-6-37
更新日期:2005-09-09 00:00:00
abstract:BACKGROUND:Interpersonal Psychotherapy (IPT) is recommended in most depression treatment guidelines and proved to be a suitable treatment for elderly depressed patients. Despite the favorable results of IPT in research populations, the dissemination to general practice is surprisingly limited. Little is known about upt...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-8-52
更新日期:2007-09-13 00:00:00
abstract:BACKGROUND:Female urinary incontinence is underdiagnosed and undertreated in primary care. There is little evidence on factors that determine whether women with urinary incontinence are referred to specialist services. This study aimed to investigate characteristics associated with referrals from primary to specialist ...
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doi:10.1186/s12875-020-01282-y
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pub_type: 杂志文章
doi:10.1186/1471-2296-7-33
更新日期:2006-05-24 00:00:00
abstract:BACKGROUND:A territory-wide diabetes management program (Risk Assessment Management Program - RAMP) was recently established, providing comprehensive management for all diabetics, helping to delineate current level of control and complications prevalence among primary care diabetic patients in Hong Kong. METHOD:This c...
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pub_type: 杂志文章
doi:10.1186/1471-2296-15-8
更新日期:2014-01-10 00:00:00
abstract:BACKGROUND:In Malta, sickness certificates are needed from the first day of illness, and are issued by family physicians (FPs) either employed by the government primary health care system, self-employed in private practice, or employed by an employer for this purpose alone. The latter system, when applied by the employ...
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pub_type: 杂志文章
doi:10.1186/1471-2296-4-2
更新日期:2003-03-27 00:00:00
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doi:10.1186/1471-2296-14-36
更新日期:2013-03-18 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2010-10-06 00:00:00
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journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
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更新日期:2011-12-30 00:00:00
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更新日期:2017-12-28 00:00:00
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pub_type: 杂志文章
doi:10.1186/1471-2296-12-100
更新日期:2011-09-26 00:00:00
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pub_type: 杂志文章
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更新日期:2014-06-05 00:00:00
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pub_type: 杂志文章
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更新日期:2002-10-14 00:00:00
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pub_type: 杂志文章
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更新日期:2014-11-25 00:00:00
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pub_type: 杂志文章
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