Impact Of Target Specific Oral Anticoagulants On Quality Of Life

Abstract

tensive (HTN) patients. Methods: The study included adults (18 yrs. or older) HTN patients covered by commercial and Medicare Supplemental insurance in the Truven MarketScan database with an HTN diagnosis between October 2009 and December 2011. At least two filled prescriptions for Exforge HCT or two periods of minimum 15 days of concurrent use of amlodipine, valsartan and hydrochlorothiazide (FC cohort) were required. Patients were continuously enrolled at least 12 months before and 12 month after the index prescription and had valsartan initial dose of 160 or 320 mg/day. Adherence was measured with proportion of days covered (PDC) and medication possession ratio (MPR). Persistence was defined as no treatment gap greater than 30 days. Chi-Square tests and independent sample t-tests were used after adequate propensity score matching (PSM) (absolute standardized differences < 0.1) using demographics, comorbidities, pre-index health care utilization , pre-index costs and valsartan initial dose. Results: Exforge HCT patients (N= 9,221) had better unadjusted outcomes compared to FC patients (N= 1,884): higher MPR (81.6% vs 77.0%), PDC (70.0% vs 60.6%) and persistence (42.7% vs 23.6%) (all p< 0.0001). After risk-adjustment with PSM, Exforge HCT patients also exhibited better outcomes compared to FC patients: higher adherence (85.7% vs 77.0%), higher PDC (73.8% vs 60.6%) and persistence (46.8% vs 23.6%) (all p< 0.0001). More patients had MPR> 80% in the Exforge HCT cohort (72.9% vs 57.5%, p< 0.0001). ConClusions: Real-world data indicate that Exforge HCT is associated with improved adherence and persistence compared to amlodipine/ valsartan/hydrochlorothiazide FC. These data should be considered by stakeholders engaged with optimizing outcomes of HTN patients.objeCtives: Diet and exercise along with the pharmacological treatment are required for an adequate control of blood pressure among hypertensive patients. The aim of this study is to identify the drug treatments prescribed and attitudes and factors associated with the adherence to these indications. Methods: Sociodemographic and drug treatment information of hypertensive patients aged 20 years and older was obtained from an institutional health survey, Encoprevenimss 2010. Statistical relationships between socio-demographic variables and adherence to diet and exercise were tested. Two binary logistic regression models were constructed to measure the impact of personal attitudes and social and demographic variables on the decision of the patient whether to follow these recommendations. Results: Captopril was the leading prescribed drug (31.63%), followed by enalapril (22.45%) and metopropol (13.58%). The main combination of drugs recommended was captopril with metopropol. Additionally to the pharmacological treatment, 32.47% and 23.59% of the patients reported full adherence to the diet and exercise indications respectively, 24.04% and 15.78% partially complied and 11.03% and 16.63% did not comply. At 5% level of significance, statistically significant relationship...