The role of ambulatory blood pressure monitoring in enhancing medication adherence among patients with newly diagnosed hypertension: an analysis of the National Health Insurance cohort database
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Improving adherence to antihypertensive medication (AHM) is a key challenge in hypertension management. This study aimed to assess the impact of ambulatory blood pressure monitoring (ABPM) on AHM adherence.We utilized the Korean National Health Insurance Service database. Among patients newly diagnosed with hypertension who started AHM between July 2010 and December 2013, we compared clinical characteristics and adherence between 28,116 patients who underwent ABPM prior to starting AHM and 118,594 patients who did not undergo ABPM. Good adherence was defined as a proportion of days covered (PDC) of 0.8 or higher. The total study population was 146,710, with a mean age of 50.5 ± 6.4 years; 44.3% were female. Co-morbidities were noted in 4.2%. About a third of patients (33.1%) showed good adherence. The ABPM group had a notably higher PDC (total PDC: 0.64 ± 0.35 vs . 0.45 ± 0.39; P < 0.001), irrespective of the number of medications, dosing frequency, or prescription duration. After adjusting for significant clinical variables, ABPM was still closely linked with good adherence (odds ratio, 2.35; 95% confidence interval, 2.28–2.41; P < 0.001). In newly diagnosed hypertension, undergoing ABPM prior to AHM prescription appears to enhance adherence to AHM. The exact mechanisms driving this association warrant further exploration.
Abstract
Background Improving adherence to antihypertensive medication (AHM) is a key challenge in hypertension management. This study aimed to assess the impact of ambulatory blood pressure monitoring (ABPM) on AHM adherence. Methods We utilized the Korean National Health Insurance Service database. Among patients newly diagnosed with hypertension who started AHM between July 2010 and December 2013, we compared clinical characteristics and adherence between 28,116 patients who underwent ABPM prior to starting AHM and 118,594 patients who did not undergo ABPM. Good adherence was defned as a proportion of days covered (PDC) of 0.8 or higher. Results The total study population was 146,710, with a mean age of 50.5±6.4 years; 44.3% were female. Comorbidities were noted in 4.2%. About a third of patients (33.1%) showed good adherence. The ABPM group had a notably higher PDC (total PDC: 0.64±0.35 vs. 0.45±0.39; P<0.001), irrespective of the number of medications, dos‑ ing frequency, or prescription duration. After adjusting for signifcant clinical variables, ABPM was still closely linked with good adherence (odds ratio, 2.35; 95% confdence interval, 2.28–2.41; P<0.001). Conclusions In newly diagnosed hypertension, undergoing ABPM prior to AHM prescription appears to enhance adherence to AHM. The exact mechanisms driving this association warrant further exploration.
참고문헌 (34)
- Mills KT, "The global epidemiology of hypertension", Nat Rev Nephrol, 16(4), pp.223~237 (2020)
- Ettehad D, "Blood pressure lowering for prevention of cardiovascular disease and death : a systematic review and meta-analysis", Lancet, 387(10022), pp.957~967 (2016)
- Blood Pressure Lowering Treatment Trialists’ Collaboration, "Age-stratified and blood-pressure-stratified effects of blood-pressure-lowering pharmacotherapy for the prevention of cardiovascular disease and death : an individual participant-level data meta-analysis", Lancet, 398(10305), pp.1053~1064 (2021)
- Choudhry NK, "Medication adherence and blood pressure control : a scientific statement from the American Heart Association", Hypertension, 79(1), pp.e1~e14 (2022)
- Kim J, "Effect of adherence to antihypertensive medication on the long-term outcome after hemorrhagic stroke in Korea", Hypertension, 72(2), pp.391~398 (2018)
- Ruppar TM, "Medication adherence interventions improve heart failure mortality and readmission rates : systematic review and meta-analysis of controlled trials", J Am Heart Assoc, 5(6), pp.e002606~ (2016)
- Simpson SH, "A meta-analysis of the association between adherence to drug therapy and mortality", BMJ, 333(7557), pp.15~ (2006)
- Burnier M, "Adherence in hypertension", Circ Res, 124(7), pp.1124~1140 (2019)
- Hamrahian SM, "Medication non-adherence : a major cause of resistant hypertension", Curr Cardiol Rep, 22(11), pp.133~ (2020)
- Gosmanova EO, "Impact of non-adherence on renal and cardiovascular outcomes in US veterans", Am J Nephrol, 42(2), pp.151~157 (2015)
- Lee H, "Adherence to antihypertensive medication and incident cardiovascular events in young adults with hypertension", Hypertension, 77(4), pp.1341~1349 (2021)
- Kim S, "Medication adherence and the risk of cardiovascular mortality and hospitalization among patients with newly prescribed antihypertensive medications", Hypertension, 67(3), pp.506~512 (2016)
- Mennini FS, "Cost of poor adherence to anti-hypertensive therapy in five European countries", Eur J Health Econ, 16(1), pp.65~72 (2015)
- Huang QF, "Ambulatory blood pressure monitoring to diagnose and manage hypertension", Hypertension, 77(2), pp.254~264 (2021)
- Cepeda M, "Status of ambulatory blood pressure monitoring and home blood pressure monitoring for the diagnosis and management of hypertension in the US : an up-to-date review", Hypertens Res, 46(3), pp.620~629 (2023)
- O’Brien E, "European Society of Hypertension position paper on ambulatory blood pressure monitoring", J Hypertens, 31(9), pp.1731~1768 (2013)
- Staessen JA, "Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension. Systolic Hypertension in Europe Trial Investigators", Jama, 282(6), pp.539~546 (1999)
- Boggia J, "Prognostic accuracy of day versus night ambulatory blood pressure : a cohort study", Lancet, 370(9594), pp.1219~1229 (2007)
- Salles GF, "Prognostic effect of the nocturnal blood pressure fall in hypertensive patients : the ambulatory blood pressure collaboration in patients with hypertension(ABC-H)meta-analysis", Hypertension, 67(4), pp.693~700 (2016)
- Williams B, "2018 ESC", ESH guidelines for the management of arterial hypertension, 2018, pp.39(33), 3021~3104
- Whelton PK, "2017 ACC", AHA, ABC, pp.ACPM, AGS[DOI]
- Kim HL, "The 2022 focused update of the 2018 Korean Hypertension Society Guidelines for the management of hypertension", Clin Hypertens, 29(1), pp.11~ (2023)
- Hill MN, "Adherence and persistence with taking medication to control high blood pressure", J Am Soc Hypertens, 5(1), pp.56~63 (2011)
- Cappuccio FP, "Blood pressure control by home monitoring : meta-analysis of randomised trials", BMJ, 329(7458), pp.145~ (2004)
- Uhlig K, "Self-measured blood pressure monitoring in the management of hypertension : a systematic review and meta-analysis", Ann Intern Med, 159(3), pp.185~194 (2013)
- Prieto-Merino D, "Estimating proportion of days covered(PDC)using real-world online medicine suppliers’ datasets", J Pharm Policy Pract, 14(1), pp.113~ (2021)
- Dalli LL, "Towards better reporting of the proportion of days covered method in cardiovascular medication adherence : a scoping review and new tool TEN-SPIDERS", Br J Clin Pharmacol, 88(10), pp.4427~4442 (2022)
- Lovibond K, "Cost-effectiveness of options for the diagnosis of high blood pressure in primary care : a modelling study", Lancet, 378(9798), pp.1219~1230 (2011)
- Palla M, "Masked hypertension and cardiovascular outcomes : an updated systematic review and meta-analysis", Integr Blood Press Control, 11, pp.11~24 (2018)
- Mancia Chairperson G, "2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension Endorsed by the European Renal Association(ERA)and the International Society of Hypertension(ISH)", J Hypertens, 41, pp.1874~ (2023)
- Grant RW, "Impact of concurrent medication use on statin adherence and refill persistence", Arch Intern Med, 164(21), pp.2343~2348 (2004)
- Kim SJ, "Impact of number of medications and age on adherence to antihypertensive medications : a nationwide population-based study", Medicine(Baltimore), 98(49), pp.e17825~ (2019)
- Chapman RH, "Predictors of adherence with antihypertensive and lipid-lowering therapy", Arch Intern Med, 165(10), pp.1147~1152 (2005)
- Osterberg L, "Adherence to medication", N Engl J Med, 353(5), pp.487~497 (2005)