Saleh Shadi S, Szebenyi Steven, Carter Judith A, Zacher Chris, Belletti Dan
Department of Health Policy, Management, and Behavior, School of Public Health, State University of New York at Albany, Rensselaer, NY, USA.
J Clin Hypertens (Greenwich). 2008 Jan;10(1):43-50. doi: 10.1111/j.1524-6175.2007.07307.x.
This study sought to identify patterns of antihypertensive drug modifications in initial drug therapy as well as to examine the effect of modifications on costs. The study population included adults who initiated antihypertensive drug therapy during 12 months of therapy. Approximately three-fourths of study participants had a change in therapy within the first 12 months of treatment. Discontinuation (57.1%) of antihypertensive drug treatment was the most prevalent modification type, followed by titrations (14.6%). Initiating treatment with fixed-dose combinations was associated with the lowest likelihood of a nondiscontinuation modification (12.5%); the use of 2 separate drugs was associated with the least likelihood of complete discontinuation (28.7%). The presence of therapy changes was associated with increased health services costs in the first 12 months of antihypertensive drug therapy. Clinicians and payers should be aware of the association between starting specific antihypertensive treatment regimens and the likelihood of changes in medication and changing costs.
本研究旨在确定初始药物治疗中降压药物调整的模式，并考察这些调整对成本的影响。研究人群包括在12个月治疗期间开始进行降压药物治疗的成年人。大约四分之三的研究参与者在治疗的前12个月内有治疗方案的改变。降压药物治疗的停药（57.1%）是最常见的调整类型，其次是滴定调整（14.6%）。开始使用固定剂量复方制剂治疗时，非停药调整的可能性最低（12.5%）；使用两种单独药物时，完全停药的可能性最小（28.7%）。在降压药物治疗的前12个月中，治疗方案的改变与医疗服务成本增加有关。临床医生和支付方应意识到开始特定降压治疗方案与药物改变可能性及成本变化之间的关联。
