Key result
Among Chinese patients on CCB monotherapy, 180-day compliance was 85.0%, with younger age, male sex (aOR 0.89; 95% CI 0.82-0.96), and new visits associated with higher risk of noncompliance.
Why the study?
What factors are associated with compliance, discontinuation, and switching of calcium channel blockers in Chinese patients?
Observational (n=20,156)
What factors are associated with compliance, discontinuation, and switching of calcium channel blockers in Chinese patients?
In Chinese patients prescribed CCB monotherapy, younger age, male gender, and new visits are associated with higher rates of noncompliance, discontinuation, or switching.
May flag younger males and new patients for adherence support; leaves open whether interventions reduce CCB discontinuation in this cohort.
BACKGROUND: Noncompliance and nonpersistence to antihypertensive drugs is a recognized worldwide problem. Calcium channel blockers (CCBs) are commonly prescribed among Chinese patients yet few studies have been conducted to study the factors associated with their compliance, discontinuation, and switching profiles. METHODS: From clinical databases we studied 20,156 patients prescribed a CCB as their antihypertensive monotherapy from January 2004 to June 2007 in a large Territory of Hong Kong. We evaluated their compliance by medication possession ratios (MPRs), cumulative incidences of discontinuation and switching within 180 days after the prescription; and evaluated their associated factors using multivariable logistic regression analyses. RESULTS: The crude compliance level, discontinuation and switching rates at 180 days were 85.0, 3.1, and 5.0%, respectively. Older patients (aged > or =50 years; adjusted odds ratio (aOR) 1.21-1.34, P < 0.001), female gender (aOR 0.89, 95% confidence interval (CI) 0.82-0.96 for males, P = 0.004), fee payers (aOR 1.09, 95% CI 1.00-1.20, P = 0.050), service settings in family medicine specialist clinic (FMSC) (aOR 1.64, 95% CI 1.33-2.01, P < 0.001), and follow-up visits (aOR 3.24, 95% CI 2.93-3.58, P < 0.001) were positively associated with good compliance. Younger age and new visits were significantly associated with drug discontinuation or switching. CONCLUSIONS: Younger patients, male subjects, and new visitors were more likely to be noncompliant to CCB among ethnic Chinese. They represent the target subjects where primary care physicians should spend more effort on patient education to improve drug compliance.
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Wong et al. (2009) conducted an observational in Hypertension (n=20,156). Calcium channel blockers (CCBs) was evaluated on Compliance (by medication possession ratios), discontinuation, and switching at 180 days. Among Chinese patients on CCB monotherapy, 180-day compliance was 85.0%, with younger age, male sex (aOR 0.89; 95% CI 0.82-0.96), and new visits associated with higher risk of noncompliance.
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