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Persistence to anti...
Persistence to antihypertensive drug treatment in Swedish primary healthcare
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- Qvarnström, Miriam (author)
- Karolinska Institutet
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- Kahan, T. (author)
- Karolinska Institutet
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- Kieler, H. (author)
- Karolinska Institutet
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Brandt, L. (author)
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- Hasselstrom, J. (author)
- Karolinska Institutet
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Bostrom, K. B. (author)
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- Manhem, Karin, 1954 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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Hjerpe, P. (author)
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- Wettermark, B. (author)
- Karolinska Institutet
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(creator_code:org_t)
- 2013-07-16
- 2013
- English.
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In: European Journal of Clinical Pharmacology. - : Springer Science and Business Media LLC. - 0031-6970 .- 1432-1041. ; 69:11, s. 1955-1964
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Subject headings
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- To determine factors associated with low persistence in patients initiated on drug treatment for hypertension. Cohort study using medical records for patients with hypertension in 48 Swedish primary healthcare centres. Data were linked to national registers on dispensed drugs, hospitalizations, outpatient hospital consultations, deaths, migration, and socioeconomy. We identified 5225 patients (55 % women, mean age 61 years) initiated on antihypertensive drug treatment during 2006-2007. Persistence was measured for two years by the dispensed drugs. Patients with a gap of > 30 days between end of dispensed supply and the next dispensed prescription were classified as non-persistent. This was calculated by Kaplan-Meier analysis. Cox proportional hazard regression was used to estimate hazard ratios for discontinuation. Potential predictors included age, gender, blood pressure before initiation of therapy, cardiovascular comorbidity, educational level, country of birth, and income. Among patients with a dispensed first prescription, 26 % discontinued treatment during the first year, and a further 9 % discontinued during the second year. Discontinuation (all adjusted) was more common in men (P = 0.002) and in younger patients (30-49 years, P < 0.001). Systolic (P < 0.001) but not diastolic blood pressure was positively associated with persistence. Native-born Swedish citizens and patients born in the other Nordic countries had lower discontinuation rates than those born outside the Nordic countries (P < 0.001). Major determinants of discontinuation of antihypertensive drug treatment are male sex, young age, mild-to-moderate systolic blood pressure elevation, and birth outside of Sweden.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Farmakologi och toxikologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Pharmacology and Toxicology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)
Keyword
- Drug therapy
- Hypertension
- Persistence
- Primary health care
- Blood pressure
- Socioeconomy
- BLOOD-PRESSURE CONTROL
- MEDICATION ADHERENCE
- FOLLOW-UP
- HYPERTENSION
- THERAPY
- PRESCRIPTIONS
- METAANALYSIS
- POPULATION
- DATABASE
- PREVENTION
- Pharmacology (medical)
- Epidemiologi
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Qvarnström, Miri ...
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Kahan, T.
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Kieler, H.
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Brandt, L.
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Hasselstrom, J.
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Bostrom, K. B.
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show more...
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Manhem, Karin, 1 ...
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Hjerpe, P.
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Wettermark, B.
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Basic Medicine
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MEDICAL AND HEAL ...
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and Health Sciences
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and Public Health Gl ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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- Articles in the publication
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European Journal ...
- By the university
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University of Gothenburg
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Uppsala University
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Karolinska Institutet