Name : Alfi Rahmatika

NIM : 22010117120052
Class : A

Relationship of Blood Pressure Control and Hospitalization Risk to Medication Adherence

Among Patients With Hypertension in Taiwan
Pin-Hsuan Wu, Chuh-Yuh Yang, Zhi-Lian Yao, Wei-Zhan Lin, Li-Wei Wun, and Chi-Ching Chang

The purpose of this study was to examine the medication adherence among patients with
hypertension and its association with blood pressure control, cardiovascular disease (CVD)
hospitalization, and all-cause hospitalization. Hypertension is a major risk factor for
cardiovascular disease, which accounts for one-third deaths in the world and is the leading cause
death in Taiwan. In worldwide, the prevalence of hypertension was around 26% in 2000, and is
about to rise by 2025. The study used a retrospective cohort observation of patients who were
treated for hypertension from January 2005 to December 2006.

Medication adherence is explained as the extent to which the patient actively takes the
medications as prescribed by the physician, based on the the treatment alliance established
between the physician and the patient. There are two methods for measuring medication
adherence, direct and indirect. Indirect methods include pill counts, ascertaining rates of
prescription refills, and electronic medication monitors. This study calculated the proportion of
days covered (PDC) by filled prescriptions to determine the degree of medication adherence,
which was measured as the number of days supplied with filled prescriptions divided by the total
days of each patient’s observation period. For hospitalized patients, the denominator was the
total days from the first prescription date in January 2005 to the day before hospitalization in
2006. For nonhospitalized patients, the denominator was the total days from the first prescription
date in 2005 to the end of the last refill in December 2006. Patients were characterized as
adherent if they had PDC at least 80%.

The subjects of this study were 29.865 hypertension patients. In total, 85.5% of patients
were categorized as adherent, with PDC > 80; 60% of adherent patients had good blood pressure
control. The multiple logistic regression analysis also revealed that poor medication adherence
significantly increased the risks of CVD hospitalization and all-cause hospitalization. Age and
Charlson cormobidity index were significantly associated with CVD , whereas age, sex, and
Charlson cormobidity index were significantly related to all-cause hospitalization risk.

From the result of this study, the major conclusion was that high adherence to
antihypertensive therapy can help achieve satisfactory blood pressure control and reduce the risk
of Cardiovascular Disease (CVD) or all-cause hospitalization. Health-care systems or disease
management programs should thus aim to enhance patients’ awereness of the association
between poor medication adherence and the risk of adverse health outcomes.