Degli Esposti Luca, Di Martino Mirko, Saragoni Stefania, Sgreccia Andrea, Capone Alessandro, Buda Stefano, Esposti Ezio Degli
CliCon Srl-Health, Economics, and Outcomes Research, Ravenna, Italy.
J Clin Hypertens (Greenwich). 2004 Feb;6(2):76-84. doi: 10.1111/j.1524-6175.2004.03044.x.
The objective of the research was to perform a clinical practice-based analysis of how long patients remain on various antihypertensive drugs. An administrative database listing of patient baseline characteristics, drug prescriptions, and hospital admissions was used. All new users of antihypertensive drugs, > or =20 years of age, receiving a first prescription for diuretics, beta blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, or angiotensin II receptor antagonists between January 1, 2000, and December 31, 2000, were included and observed for 365 days. Persistence was defined as a duration of therapy <273 days. A total of 14,062 patients were included in the study, 39.7% of whom remained on treatment (persistent patients). Persistent patients were more likely to be older, taking other drugs for concurrent disorders, hospitalized for cardiovascular diseases, and initially prescribed angiotensin II receptor antagonists. Persistent patients accounted for 80.6% of the overall cost for antihypertensive drugs. Factors associated with drug cost were age, pattern of persistence, number of prescribed classes, and specific medication at enrollment. Measuring persistence with treatment is needed to evaluate the appropriateness and the cost-effectiveness of drug use.
该研究的目的是基于临床实践分析患者使用各类抗高血压药物的时长。使用了一个列出患者基线特征、药物处方和住院情况的管理数据库。纳入了2000年1月1日至2000年12月31日期间年龄≥20岁、首次接受利尿剂、β受体阻滞剂、钙通道阻滞剂、血管紧张素转换酶抑制剂或血管紧张素II受体拮抗剂处方的所有抗高血压药物新使用者，并对其进行了365天的观察。持续性定义为治疗时长<273天。共有14062名患者纳入研究，其中39.7%持续接受治疗（持续性患者）。持续性患者更有可能年龄较大、因并发疾病服用其他药物、因心血管疾病住院，且最初处方为血管紧张素II受体拮抗剂。持续性患者占抗高血压药物总成本的80.6%。与药物成本相关的因素有年龄、持续性模式、处方类别数量以及入组时的具体用药。需要衡量治疗的持续性以评估药物使用的合理性和成本效益。
