Antihypertensive medication persistence and adherence among non-Hispanic Asian US patients with hypertension and fee-for-service Medicare health insurance

Less than 50% of non-Hispanic Asian adults taking antihypertensive medication have controlled blood pressure. We compared non-persistence and low adherence to antihypertensive medication between non-Hispanic Asian and other race/ethnicity groups among US adults ≥66 years who initiated antihypertensi...

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Veröffentlicht in:PloS one Jg. 19; H. 3; S. e0300372
Hauptverfasser: Choi, Eunhee, Mizuno, Hiroyuki, Wang, Zhixin, Fang, Chloe, Mefford, Matthew T., Reynolds, Kristi, Ghazi, Lama, Shimbo, Daichi, Muntner, Paul
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Public Library of Science 20.03.2024
Public Library of Science (PLoS)
Schlagworte:
Adult
Aged
Antihypertensive Agents - therapeutic use
Antihypertensive drugs
Comparative analysis
Complications and side effects
Drug therapy
Ethnicity
Evaluation
Humans
Hypertension
Medicare
Medication Adherence
Medicine and Health Sciences
Patient compliance
Patient outcomes
People and Places
Social Sciences
United States
United States
ISSN:1932-6203, 1932-6203
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Zusammenfassung:Less than 50% of non-Hispanic Asian adults taking antihypertensive medication have controlled blood pressure. We compared non-persistence and low adherence to antihypertensive medication between non-Hispanic Asian and other race/ethnicity groups among US adults ≥66 years who initiated antihypertensive medication between 2011 and 2018 using a 5% random sample of Medicare beneficiaries (non-Hispanic Asian, n = 2,260; non-Hispanic White, n = 56,000; non-Hispanic Black, n = 5,792; Hispanic, n = 4,212; and Other, n = 1,423). Non-persistence was defined as not having antihypertensive medication available to take in the last 90 of 365 days following treatment initiation. Low adherence was defined as having antihypertensive medication available to take on <80% of the 365 days following initiation. In 2011-2012, 2013-2014, 2015-2016 and 2017-2018, the proportion of non-Hispanic Asian Medicare beneficiaries with non-persistence was 29.1%, 25.6%, 25.4% and 26.7% (p-trend = 0.381), respectively, and the proportion with low adherence was 58.1%, 54.2%, 53.4% and 51.6%, respectively (p-trend = 0.020). In 2017-2018, compared with non-Hispanic Asian beneficiaries, non-persistence was less common among non-Hispanic White beneficiaries (risk ratio 0.74 [95%CI, 0.64-0.85]), non-Hispanic Black beneficiaries (0.80 [95%CI 0.68-0.94]) and those reporting Other race/ethnicity (0.68 [95%CI, 0.54-0.85]) but not among Hispanic beneficiaries (1.04 [95%CI, 0.88-1.23]). Compared to non-Hispanic Asian beneficiaries, non-Hispanic White beneficiaries and beneficiaries reporting Other race/ethnicity were less likely to have low adherence to antihypertensive medication (relative risk 0.78 [95%CI 0.72-0.84] and 0.84 [95%CI 0.74-0.95], respectively); there was no association for non-Hispanic Black or Hispanic beneficiaries. Non-persistence and low adherence to antihypertensive medication were more common among older non-Hispanic Asian than non-Hispanic White adults.
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Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0300372