NEW YORK (Reuters Health) – Nearly one out of six patients in China who is prescribed an antihypertensive agent will discontinue treatment within 6 months. Multiple factors affect poor adherence rates, including younger age, male sex, being drug naive, low socioeconomic status and being on a beta-blocker, according to a study conducted at the Chinese University of Hong Kong.

When compared with drug-compliant Chinese patients, non-compliant patients were younger than 50 years old, seen at a family medicine specialist clinic (as opposed to the general outpatient clinics) and to have other comorbidity More discontinuers were prescribed beta-blockers, and fewer were given calcium channel blockers and combination therapies.

“These data suggest that more meticulous monitoring of patient adherence is required in patients with these characteristics,” Dr. Johnny Y. Jiang and co-investigators write in the July issue of the American Journal of Hypertension.

This lack of adherence to antihypertensive therapy imposes a substantial health burden, as well as higher costs to health care systems. However, research into this issue has been conducted almost exclusively among Caucasian populations.

Little is known about how these drugs affect Chinese patients with high blood pressure. As the authors note, noncompliance with medication could be due to “ethnic differences in the pharmacological effect of different antihypertensive agents.”

Dr. Jiang’s group obtained data from the computerized patient recording system of the Hospital Authority of Hong Kong. The study cohort included 93,286 adult patients who received an antihypertensive drug between 2004 and 2007.

The overall rate of drug discontinuation within 180 days was 13.2%, and 17.7% for patients prescribed their first antihypertensive drug.

“From a health-system point of view, (these findings raise) the need to implement more innovative and realistic chronic disease models of disease management,” Dr. Jiang and associates maintain.

They continue: “This consists of patient-professional partnership, multidisciplinary team approach, self management education, clinical information systems, and development of decision support and clinical indicators so that patient adherence to antihypertensive drugs could be further enhanced.”

Reference:
Am J Hypertens 2009:22:802-810.