Abstract:
PURPOSE:Poor adherence and persistence to blood pressure lowering (BPL) agents leads to increased risk of morbidity and mortality. The aim of this study was to investigate the long-term adherence, persistence, and re-initiation of BPL agents among older Australians (aged ≥65 years). METHODS:We utilised the Pharmaceutical Benefits Scheme data covering a 10% random sample of Australians. We identified 31 088 older Australians (mean age, 75.4 years; 56% females) with newly initiated BPL therapy from 2008 to 2016. Adherence was assessed using the proportion of days covered (PDC) at 6-month intervals. Discontinuation was defined as ≥90 days without BPL coverage. Cox regression was applied to compare the time till the first discontinuation of BPL agents across different BPL categories and among various subgroups. RESULTS:Over a mean follow-up of 3.8 years, 40% to 70% of older Australians received a BPL agent discontinued it. The median time to discontinuation ranged from 159 to 373 days. Persistence with fixed dose combinations was the best (68%, 58%, and 41% at 6, 12, and 36 months respectively), followed by angiotensin II receptor blockers (69%, 58%, and 40%), beta-blockers (67%, 54%, and 36%), angiotensin converting enzyme inhibitors (62%, 51%, and 34%), calcium channel blockers (57%, 47%, and 31%), and diuretics (59%, 41%, and 23%). Among those who discontinued, 30% to 50% re-initiated, with median days to re-initiation ranging from 177 to 302. Only 21% to 42% of the study population maintained "good" adherence (PDC ≥ 0.8) to BPLs over 3 years. CONCLUSION:Compliance to BPL agents is poor among older Australians. Interventions to enhance adherence and persistence to BPL agents are needed.
journal_name
Pharmacoepidemiol Drug Safjournal_title
Pharmacoepidemiology and drug safetyauthors
Si S,Ofori-Asenso R,Briffa T,Sanfilippo FM,Ilomaki J,Qin X,Tacey M,Reid CM,Liew Ddoi
10.1002/pds.4742subject
Has Abstractpub_date
2019-06-01 00:00:00pages
788-795issue
6eissn
1053-8569issn
1099-1557journal_volume
28pub_type
杂志文章abstract:BACKGROUND:Granular clinical and laboratory data available in electronic health record (EHR) databases provide researchers the opportunity to conduct investigations that would not be possible in insurance claims databases; however, for pharmacoepidemiology studies, accurate classification of medication exposure is crit...
journal_title:Pharmacoepidemiology and drug safety
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abstract::The use of healthcare databases in research provides advantages such as increased speed, lower costs and limitation of some biases. However, database research has its own challenges as studies must be performed within the limitations of resources, which often are the product of complex healthcare systems. The primary ...
journal_title:Pharmacoepidemiology and drug safety
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journal_title:Pharmacoepidemiology and drug safety
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journal_title:Pharmacoepidemiology and drug safety
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journal_title:Pharmacoepidemiology and drug safety
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abstract::Intravenous immunoglobulins (i.v.IG) are increasingly used in various clinical situations for which they have been considered to be safe and effective. However, since 1987, some cases of renal toxicity have been reported. Forty-nine cases of acute renal failure have been notified to the French Regional Pharmacovigilan...
journal_title:Pharmacoepidemiology and drug safety
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doi:10.1002/(sici)1099-1557(199904)8:1+
更新日期:1999-04-01 00:00:00
abstract::Analysing duration of treatment episodes has become a standard task in many pharmacoepidemiological studies. However, such analyses are often carried out in a rather simplistic manner and more subtle issues are often ignored. In this paper, methods of analysing duration treatment episodes beyond simple analyses allowi...
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abstract:BACKGROUND:The Epidemiologic Registry of Cystic Fibrosis (ERCF) was a multicentre, longitudinal follow-up project of cystic fibrosis patients enrolled at some 200 centres in nine European countries between 1994 and 1999. PURPOSE:We aimed to assess and improve the quality of a subset of data from the ERCF relating to s...
journal_title:Pharmacoepidemiology and drug safety
pub_type: 杂志文章,多中心研究
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更新日期:2003-09-01 00:00:00
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journal_title:Pharmacoepidemiology and drug safety
pub_type: 杂志文章
doi:10.1002/pds.1328
更新日期:2007-01-01 00:00:00
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更新日期:2008-01-01 00:00:00
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journal_title:Pharmacoepidemiology and drug safety
pub_type: 杂志文章
doi:10.1002/(SICI)1099-1557(199807/08)7:4<275::AID-PDS
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journal_title:Pharmacoepidemiology and drug safety
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journal_title:Pharmacoepidemiology and drug safety
pub_type: 杂志文章
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更新日期:2018-01-01 00:00:00
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journal_title:Pharmacoepidemiology and drug safety
pub_type: 杂志文章
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journal_title:Pharmacoepidemiology and drug safety
pub_type: 杂志文章
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更新日期:2000-03-01 00:00:00
abstract:PURPOSE:The role of administrative databases for research on drug safety during pregnancy can be limited by their inaccurate assessment of the timing of exposure, as the gestational age at birth is typically unavailable. Therefore, we sought to develop and validate algorithms to estimate the gestational age at birth us...
journal_title:Pharmacoepidemiology and drug safety
pub_type: 杂志文章
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更新日期:2013-01-01 00:00:00