Nonadherence to angiotensin-converting enzyme inhibitors and/or angiotensin II receptor blockers among high-risk patients with diabetes in Medicare Part D programs

Journal of the American Pharmacists Association : JAPhA
Yi YangWilliam B Lobb

Abstract

To identify predictors of nonadherence to angiotensin-converting enzyme inhibitors (ACEIs) and/or angiotensin II receptor blockers (ARBs) and to assess the association between nonadherence to ACEIs/ARBs and potentially avoidable hospitalizations (PAHs) among elderly high-risk patients with diabetes. Medicare Part D enrollees from six states who had diabetes and coexisting hypertension and/or renal disease, were aged 65 years or older, and who had filled at least one prescription for ACEIs/ARBs in the first 6 months of 2006 were included in this retrospective cohort study. The primary outcomes of interests were patient nonadherence to ACEI/ARB therapy, which was defined as a proportion of days covered (PDC) less than 0.8 and PAH for diabetes during the patient follow-up period (July 1, 2006, to March 31, 2007). A total of 599,141 patients (mean [+/-SD] age 75.6 +/-7.3 years, 66% women, 63% white, 15% black, and 9% Hispanic) were included. Among them, 46% were nonadherent to ACEI/ARB therapy and 6.3% had a PAH during the follow-up period. In multivariate logistic regressions, patients with diabetes and both hypertension and renal disease and patients with diabetes and renal disease only were 24% and 15% more likely, respectively,...Continue Reading

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Citations

Sep 14, 2014·Journal of the American Pharmacists Association : JAPhA·Janeen DuChaneIan Duncan
Jun 19, 2012·Journal of the American Geriatrics Society·Holly M HolmesJames S Goodwin
Feb 1, 2018·Journal of Managed Care & Specialty Pharmacy·Christina A SpiveyMarie Chisholm-Burns
Nov 30, 2021·PloS One·Justin G TrogdonJennifer L Lund

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