Key result
Taking ≥9 medications is linked to ~17% higher odds of antihypertensive non-adherence versus 1-8 medications.
Why the study?
The study sought to investigate the effects of the number of medications and age on antihypertensive medication adherence in a real-world setting using a nationwide representative cohort.
How do the total number of medications and age impact adherence to antihypertensive therapy in adult patients?
Cohort (n=150,550)
Yes
How do the total number of medications and age impact adherence to antihypertensive therapy in adult patients?
Antihypertensive medication adherence peaks in patients taking 3-4 total medications and those aged 60-69 years, with significant declines in adherence seen in patients taking 9 or more medications.
Answers are grounded in this paper and cite their sources.
May support adherence monitoring for patients on ≥9 medications; leaves open causal effects of deprescribing in hypertension cohorts.
This study tried to investigate the effects of number of medications and age on antihypertensive medication adherence in a real-world setting using a nationwide representative cohort.We obtained data from the National Health Insurance Service-National Sample Cohort (NHIS-NSC) of Korea, which is a sample of 2.2% (N = 1,048,061) of total population (N = 46,605,433). Patients aged 20 years or older (N = 150,550) who took antihypertensive medications for at least 1 year were selected. Medication possession ratio (MPR) was used for measuring adherence. The subjects were divided into 5 subgroups according to total number of medications: 1-2, 3-4, 5-6, 7-8, and 9 or more. The mean age and the mean number of medications were 60.3 ± 12.6 years and 4.1 ± 2.2, respectively. The mean MPR was 80.4 ± 23.9%, and 66.9% (N = 100,645) of total subjects were adherent (MPR ≥ 80%). The overall tendency of antihypertensive medication adherence according to the total number of medications displayed an inverted U-shape with a peak at 3-4 drugs. Adherence consistently increased as the age increased until age 69 and started to decrease from age 70. The proportion of adherent patients (MPR ≥ 80%) according to the total number of medications also showed an inverted U-shape with a peak at 3-4 drugs. When the same number of drugs was taken, the proportion of adherent patients according to age featured an inverted U- shape with a peak at 60 to 69 years. Patients taking 9 or more total drugs had the overall odds ratio (95% CI) of non-adherence (MPR < 80%) with 1.17 (1.11-1.24) compared with those taking 1 to 8 total drugs and the odds ratios in the age subgroups of 40 to 49, 50 to 59, 60 to 69 years were 1.57 (1.31-1.87), 1.21 (1.08-1.36), and 1.14 (1.04-1.25), respectively (P < .05).Association between age, total number of medications, and antihypertensive adherence displayed an inverted U-shape with a peak at 3 to 4 total medications and at age 60 to 69 years. When the total number of drugs was 9 or more, adherence decreased prominently, regardless of age.
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Kim et al. (2019) conducted a cohort in Hypertension (n=150,550). Taking 9 or more total medications vs. Taking 1 to 8 total medications was evaluated on Non-adherence to antihypertensive medications (MPR < 80%) (OR 1.17, 95% CI 1.11-1.24, p=<.05). Taking 9 or more total medications was associated with increased odds of antihypertensive medication non-adherence compared with taking 1 to 8 medications (OR 1.17; 95% CI 1.11-1.24; P<.05).
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