A comparison between antihypertensive medication adherence and treatment intensification as potential clinical performance measures
Circulation: Cardiovascular Quality and Outcomes,

Vigen R et al. – Patient adherence to antihypertensive medications is not associated with blood pressure (BP) control at the clinic level and may not be suitable as a performance measure. TI is associated with BP control, but its use as a performance measure may be constrained by challenges in measuring it and by concerns about unintended consequences of aggressive hypertension treatment in some subgroups of patients.

Methods
  • Authors included 162 879 patients among 89 clinics in the Cardiovascular Research Network Hypertension Registry with incident hypertension who were started on antihypertensive medications.
  • Adherence was measured by the proportion of days covered (PDC).
  • TI was defined by the standard based method with scores ranging between –1 to 1 and categorized as: –1 indicated no TI occurred when BP was elevated; 0 indicated TI occurred when BP was elevated; and 1 indicated that TI was made at all visits, even when BP was not elevated.
  • Logistic regression models assessed the association between adherence and TI with blood pressure control (BP ≤140/90 at the clinic visit closest to 12 months after study entry) at the patient and clinic levels.
  • Mean adherence was 0.77±0.28 (PDC±SD) at the patient level and 0.78±0.05 at the clinic level.
  • Mean TI was 0.026±0.23 at the patient level and 0.01±0.04 at the clinic level.

Results
  • At the patient level, for each 0.25 increase in adherence and TI, the odds (OR) of achieving blood pressure control increased by 28% and 55%, respectively [OR for adherence, 1.28 (1.26–1.29), and for TI, 1.55 (1.53–1.57)].
  • At the clinic level, each 0.04 increment increase in treatment intensification was associated with a 25% increased odds of achieving blood pressure control (OR, 1.24; 95% CI, 1.21–1.27).
  • In contrast, there was an inverse association between increasing adherence and BP control (OR, 0.93; 95% confidence interval, 0.90–0.95).

Please login or register to follow this author.
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Medical Student

See All >> Messages include industry-sponsored communications and special communications from MDLinx

<

Most Popular Medical Student Articles

1 Midlife dietary vitamin D intake and subsequent performance in different cognitive domains Annals of Nutrition and Metabolism, September 16, 2014    Clinical Article

2 Association between sugar-sweetened beverages and type 2 diabetes: a meta-analysis Journal of Diabetes Investigation, November 13, 2014    Evidence Based Medicine    Review Article

3 Boiled coffee consumption and the risk of prostate cancer: follow-up of 224,234 Norwegian men 20-69 years British Journal of Cancer, December 24, 2014    Clinical Article

4 Dietary fatty acids and risk of coronary heart disease in men: The Kuopio ischemic heart disease risk factor study Arteriosclerosis, Thrombosis, and Vascular Biology, December 4, 2014    Evidence Based Medicine    Clinical Article

5 Total, caffeinated and decaffeinated coffee and tea intake and gastric cancer risk: Results from the EPIC cohort study International Journal of Cancer, October 3, 2014    Clinical Article

6 Benefits of probiotics on enteral nutrition in preterm neonates: a systematic review American Journal of Clinical Nutrition, November 7, 2014    Evidence Based Medicine    Review Article    Clinical Article

7 Pathology residency training: time for a new paradigm Human Pathology, March 25, 2014    Clinical Article

8 High protein weight loss diets in obese subjects with type 2 diabetes mellitus Nutrition, Metabolism & Cardiovascular Diseases, January 3, 2014    Clinical Article

9 The effect of bupropion XL and escitalopram on memory and functional outcomes in adults with major depressive disorder: Results from a randomized controlled trial Psychiatry Research, November 3, 2014    Clinical Article

10 Chocolate consumption and risk of diabetes mellitus in the Physicians’ Health Study American Journal of Clinical Nutrition, December 10, 2014    Review Article

11 Possible association between vitamin D deficiency and restless legs syndrome Full Text Neuropsychiatric Disease and Treatment, June 6, 2014    Free full text    Clinical Article

12 Regular fish consumption and age-related brain gray matter loss American Journal of Preventive Medicine, August 15, 2014    Clinical Article

13 Effects of regular consumption of different forms of almonds and hazelnuts on acceptance and blood lipids European Journal of Nutrition, December 12, 2014    Clinical Article

14 Vitamin D status in anorexia nervosa: A meta-analysis International Journal of Eating Disorders, December 5, 2014    Evidence Based Medicine

15 How World War 1 changed global attitudes to war and infectious diseases The Lancet, November 10, 2014    Evidence Based Medicine    Clinical Article

16 Radiographic evaluation of nasal septal deviation from computed tomography correlates poorly with physical exam findings International Forum of Allergy & Rhinology, November 24, 2014    Clinical Article

17 Vitamin and multiple-vitamin supplement intake and incidence of colorectal cancer: a meta-analysis of cohort studies Medical Oncology, December 24, 2014    Clinical Article
Exclusive Author Commentary

18 Rice consumption and risk of cardiovascular disease: Results from a pooled analysis of 3 U.S. cohorts American Journal of Clinical Nutrition, December 2, 2014    Clinical Article

19 Phase II trial of the anti-CD19 bispecific T cell–engager blinatumomab shows hematologic and molecular remissions in patients with relapsed or refractory B-precursor acute lymphoblastic leukemia Journal of Clinical Oncology, November 14, 2014    Clinical Article

20 Aerobic exercise training facilitates the effectiveness of cognitive behavioral therapy in panic disorder Depression and Anxiety, December 24, 2014    Clinical Article

Indexed Journals in Medical Student: Academic Medicine, BMC Medical Education, Medical Teachermore

Make smarter career moves with less time.

Sign up for our free job placement service today and have a dedicated career consultant help locate the right physician job for you!
Click Here for more information.

Get Started Now!

Free-of-charge, no obligation.

Terms and Conditions For M3 Career Consult

By registering with the M3 Career Consult service you authorize M3 USA Corporation to represent you in your job search. The following is a summary of the terms of our service and our mutual obligations to help you find a job:

  • You designate M3 to act as your agent and represent you in your job search;
  • You will not pay us for this service
  • You will advise us of any companies or positions to which you apply or have applied;
  • You will advise us if you believe you are not capable of performing a position for which we submit you, or for which you interview;
  • You will keep all information we provide you about companies or positions strictly confidential;
  • You will promptly provide us with information we request of you;
  • You will make yourself reasonably available for phone, video and in-person conversations and interviews;
  • You will be truthful in all of your communications with us; and
  • You will advise us if anything above changes.
 

The Top Read Articles of 2014 are Now Available

Scouring thousands of peer-reviewed journals and popular press, Our Editors just released the Top Read Articles of the Year. See the Top Read List