One-Third of Hypertension Patients Noncompliant with Therapy

More than 30% of patients with hypertension do not adhere to their antihypertensive drug therapy, according to a new study.

Researchers at the University of North Carolina (UNC, Chapel Hill, USA) conducted a study among 1,826 participants of the Atherosclerosis Risk in Communities Study, who reported hypertension without prevalent cardiovascular disease (CVD) during their annual follow-up calls in 2006 and 2007. Medication adherence was measured as more than 80% proportion days covered, by using Medicare Part D claims. Study outcomes consisted of a composite of cardiovascular events, Medicare inpatient payments, and inpatient days.

The results showed that 31.5% of the participants were noncompliant with their therapy in the three months preceding hypertension reports. Positive predictors included female gender and diabetes; African-American race and current smoking were negative predictors. After adjustment, the correlation between noncompliance and a composite end point of cardiovascular outcomes up to 2012 was not statistically significant, as were adjusted associations with Medicare inpatient days or payments. The study was published on November 3, 2016, in the Journal of Evaluation in Clinical Practice.

“Despite having medical and prescription coverage, nearly a third of hypertensive participants were not adherent to antihypertensive drug therapy,” concluded lead author Jerome Federspiel, MD, PhD. “Differences in clinical outcomes associated with nonadherence, though not statistically significant, were consistent with results from randomized trials.”

The World Health Organization estimates that only 50% of patients with chronic diseases in developed countries follow treatment recommendations. Low rates of adherence for asthma, diabetes, and hypertension are thought to contribute substantially to the human and economic burden of those conditions. Major barriers to compliance include the cost of prescription medicine, complexity of modern medication regimens, poor health literacy and lack of comprehension of treatment benefits, undiscussed side effects, and poor communication or lack of trust between patient and health-care provider.

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