These sufferers initiated treatment between January 1, 2006 and December 31, 2008. including angiotensin transforming enzyme inhibitors (37%), angiotensin receptor blockers (4%), beta blockers (21%), calcium channel blockers (8%), and diuretics (28%). Persistence to the initial drug class was 57% after 1 year and 43% after 2 years. There were no differences in persistence between diuretics and any of the other antihypertensive drug classes, after adjustment for confounders. Discontinuation (all adjusted) was more common in men (P?=?0.004), younger patients (P?0.001), those with mild systolic blood pressure elevation (P?0.001), and patients born outside the Nordic countries (P?0.001). Among 1295 patients who switched drug Prasugrel (Maleic acid) class after their first prescription, only 21% experienced a blood pressure recorded before the switch occurred; and out them 69% still experienced high blood pressures. In conclusion, there appears to be no difference in drug class persistence between diuretics and other major antihypertensive drug classes, when factors known to be associated with poor persistence are taken into account. Prasugrel (Maleic acid) Keywords: discontinuation, drug therapy, hypertension, medication persistence, primary healthcare, sex, socioeconomic factors 1.?Introduction There is extensive evidence that antihypertensive treatment reduces the risk of cardiovascular morbidity and mortality. Although blood pressure control has improved over the years, many patients with hypertension still do not reach treatment target.[2C4] You Rabbit polyclonal to Piwi like1 will find many reasons behind poor blood pressure control despite being treated; for example, inadequate dosing, few different drug classes combined, inadequate monitoring after initiation of treatment, and poor medication taking behavior. Without the appropriate period and continuity of antihypertensive drug therapy, patients will not benefit from treatment. There are a number of ways of assessing if patients are using the prescribed medicine and all methods have their own strengths and limitations. Methods used are questionnaires, interviews, pharmacy Prasugrel (Maleic acid) claims (pharmacy dispensing data), directly observed therapy, pill count, electronic monitoring, and drug or biomarker measurement in body fluids. All these methods can be used to measure adherence/compliance, that is, to the take action of conforming to the recommendations made by the supplier with respect to timing, dosage, and frequency of medication taking. However, for medication persistence, that is, the duration of time from initiation to discontinuation of therapy most of the methods mentioned above have their limitations. Consequently, longitudinal analyses of pharmacy claims data have been suggested as the golden standard in analyses of persistence. For antihypertensive drug treatment, this may be assessed either as class persistence, that is, the proportion remaining on treatment with the drug class utilized for initiation, or as therapy persistence, that is, the proportion remaining on any antihypertensive treatment. Many previous studies comparing persistence between different antihypertensive drug classes have shown lower persistence with diuretics or beta blockers.[7C13] However, these studies have limitations in their design. Some have used prescription data for antihypertensive drugs without a confirmed diagnosis Prasugrel (Maleic acid) of hypertension in the individual patient,[12,13] while others have included data only on issued prescriptions and not the actual packed prescriptions by the patients. Furthermore, few previous studies included data on important patient characteristics such as comorbidity, blood pressure before initiating drug treatment, educational level, country of birth, or income.[7C10] These individual factors may all be associated with Prasugrel (Maleic acid) differences in persistence, and are thus important to include in the analyses to minimize confounding. In a previous study on therapy persistence, where we observed persistence to any antihypertensive treatment, we found that men, younger patients, those with mild-to-moderate systolic blood pressure elevation, and patients given birth to abroad experienced lower therapy persistence. However, in this study, we want to observe if you will find differences in persistence to diuretics compared to other antihypertensive drug classes and to see if the same patient characteristics are also of importance when studying class persistence. Therefore, we determined class persistence to the major antihypertensive drug classes, and assessed.