A comparison between antihypertensive medication adherence and treatment intensification as potential clinical performance measures

Circulation. Cardiovascular Quality and Outcomes
Rebecca VigenP Michael Ho

Abstract

Medication adherence and treatment intensification have been advocated as performance measures to assess the quality of care provided. Whereas previous studies have shown that adherence and treatment intensification (TI) of antihypertensive medications is associated with blood pressure (BP) control at the patient level, less is known about whether adherence and TI is associated with BP control at the clinic level. We 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 l...Continue Reading

References

Apr 6, 2005·Journal of the American College of Cardiology·John A SpertusUNKNOWN American College of Cardiology/American Heart Association Task Force on Performance Measures
Dec 6, 2008·Journal of the American College of Cardiology·Robert O BonowUNKNOWN American Heart Association Task Force on Performance Measures
Jul 8, 2009·Hypertension·Adam J RoseNancy R Kressin
Dec 25, 2009·Circulation. Cardiovascular Quality and Outcomes·Adam J RoseNancy R Kressin
Apr 21, 2011·JAMA : the Journal of the American Medical Association·Dario Giugliano, Katherine Esposito

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Citations

Jun 17, 2015·Journal of the American Society of Hypertension : JASH·Tyler H GumsBarry L Carter
Jun 6, 2019·Circulation. Cardiovascular Quality and Outcomes·Brandon K BellowsValy Fontil
Apr 1, 2021·Journal of the American Heart Association·Beom Joon KimHee-Joon Bae
Oct 30, 2014·Circulation. Cardiovascular Quality and Outcomes·Kevin L ThomasEric D Peterson

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