Largely because of the high attack rate, non-influenza-related VRTI imposes a greater economic burden than many other clinical conditions. The pending availability of effective antiviral therapies warrants increased attention be paid to this common and expensive illness.

ardiovascular disease, the leading cause of death and disability in the United States, is associated with inadequate blood pressure (BP) control.1,2 The relationship between BP and risk of cardiovascular events is positive, continuous, consistent, and independent of other risk factors. 2 Unfortunately, BP control is particularly poor among hypertensive patients at the highest risk for cardiovascular events, including patients with diabetes and older patients with systolic hypertension (HTN). 3Randomized controlled trials conducted over the last 4 decades have provided evidence to support the effectiveness of BP lowering to reduce the risks of cardiovascular disease. 4 Pharmacologic treatment of high BP can reduce the risk of stroke by 30% to 40% and myocardial infarction (MI) by 20% to 25%.5 Failure to reach BP treatment goals contributes to the burden of HTN complications. Results of the Cardiovascular Health Study suggest that undertreating systolic BP of >140 mm Hg accounts for 34% of strokes and 22% of MIs in older adults. 6 Recent population data indicate that only 31% of all hypertensive individuals are controlled to <140/90 mm Hg.3 Thus, almost 70% of the more than 50 million Americans with high BP are at increased risk of cardiovascular complications due to the failure to reach goal BP. 2Although poor BP control can be attributed to several factors, one pivotal reason is the problem of long-term patient compliance with therapy.7 Lack of compliance with BP-lowering medication is a major reason for poor control of BP.8 Reasons for poor compliance vary. Patients with high BP may fail to take their medication because of the chronic nature of HTN and its absence of overt symptoms; other reasons that have been studied include the adverse effects of medication, complicated drug ABSTRACT OBJECTIVE: This study was conducted to evaluate the relationship between medication compliance and blood pressure (BP) control among members of 13 managed care organizations with essential hypertension (HTN) who received antihypertensive monotherapy for at least 3 pharmacy claims prior to the blood pressure measurement.METHODS: This was a retrospective review of medical and pharmacy claims over a 4-year period (1999-2002) from 13 U.S. health plans. Data were collected by trained health professionals from randomly selected patient medical records per Health Plan Employer Data and Information Set (HEDIS) technical specifications. Patients were selected if they (1) had received monotherapy or fixed-dose combination therapy (administered in one tablet or capsule) during the time BP was measured (thus those with no BP drug therapy were excluded); (2) had received 3 or more antihypertensive pharmacy claims for the antihypertensive drug therapy prior to BP measurement; and (3) had one or more antihypertensive pharmacy claims after BP was measured. Control of BP was defined according to guidelines of the Sixth Report of the Joint National Committee (JNC 6) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (<140/...

Methods: This was a retrospective, time series analysis of 27 provider groups and managed care organizations from 1998 through 2006. Patients with hypertension were identified from more than 4000 physicians. Medical charts were collected and clinical data were evaluated using prevailing JNC criteria during the time period before and after JNC 7.Results: A total of 19,258 patients were identified with hypertension: 15,258 included in the before-JNC 7 cohort and 4,000 in the after-JNC 7 cohort. BP control in the before-JNC 7 cohort was 40.8% compared with 49.3% in the after-JNC 7 cohort (P < .0001). After controlling for demographic and clinical covariates, patients in the before-JNC 7 cohort were 45% less likely to achieve BP control compared with the after-JNC 7 cohort (odds ratio, 0.551; P < .0001). Conclusion

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Rapid recovery agents for colonoscopy can improve practice efficiency and offer economic advantages over traditional sedation.