Prescriber Adherence to Antihypertensive Prescription Guidelines and the Impact of Patient Socioeconomic Factors: A Cross-Sectional Study Using Data From the Irish Longitudinal Study on Ageing.

IF 2.4 4区医学 Q3 PHARMACOLOGY & PHARMACY Pharmacoepidemiology and Drug Safety Pub Date : 2024-11-01 DOI:10.1002/pds.70025

Alizeh Akhtar, Edel Burton, Margaret Bermingham, Patricia M Kearney

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Abstract

Purpose: Uncontrolled hypertension causes significant morbidity and mortality worldwide. Several prescribing guidelines have been created to address this, however, prescriber adherence to guidelines is influenced by various sociodemographic patient factors. This study aims to determine the effects of these patient factors on prescriber adherence to antihypertensive prescription guidelines.

Methods: A secondary analysis of data from the first wave of The Irish Longitudinal Study on Ageing (TILDA), was conducted. Participants were included if they reported previous hypertension diagnoses. Antihypertensive medication regimes were compared with the prescribing guidance in the 2011 NICE hypertension guidelines. The effects of patient sociodemographic factors on prescriber adherence to guidelines, and the effect of prescriber adherence on blood pressure control (≥ 140/90 mmHg), were determined using binomial logistic regression models.

Results: A total of 2992 participants were included in this analysis; 54.9% female with mean age 65.7 years (±9.23). Male sex and older age, and lower socioeconomic status were associated with increased prescriber guideline adherence. Prescribers were less likely to adhere to guidelines in female patients ≥ 55 years (Relative Risk [RR] 0.75 [0.62, 0.91]), and female patients across all age groups (RR 0.80 [0.67, 0.95]). Better blood pressure control was seen with medication regimes adherent to prescription guidelines (140.38 (±18.98)/83.09 (±11.02) mmHg adherent vs. 141.66 (±19.86)/84.77 (±11.71) mmHg non-adherent).

Conclusions: This study highlights the effect of patient sex on prescriber adherence to antihypertensive prescription guidelines, emphasizing a larger issue of systemic undertreatment of females observed within healthcare. Further research is needed to determine the reasons for such differences in hypertensive care.

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开处方者遵守抗高血压处方指南的情况及患者社会经济因素的影响：使用爱尔兰老龄化纵向研究数据的横断面研究》。

目的：在全球范围内，未得到控制的高血压会导致严重的发病率和死亡率。为了解决这一问题，已经制定了一些处方指南，但是，处方者对指南的遵守情况受到患者各种社会人口因素的影响。本研究旨在确定这些患者因素对处方者遵守抗高血压处方指南的影响：方法：对第一波爱尔兰老龄化纵向研究（TILDA）的数据进行了二次分析。如果参与者曾报告过高血压诊断，则将其纳入研究范围。将抗高血压药物治疗方案与 2011 年 NICE 高血压指南中的处方指导进行了比较。使用二项式逻辑回归模型确定了患者社会人口因素对处方者遵守指南的影响，以及处方者遵守指南对血压控制（≥ 140/90 mmHg）的影响：本次分析共纳入 2992 名参与者，其中女性占 54.9%，平均年龄为 65.7 岁（±9.23）岁。男性、高龄和较低的社会经济地位与处方者更多地遵守指南有关。年龄≥55岁的女性患者（相对风险[RR] 0.75 [0.62, 0.91]）和所有年龄组的女性患者（RR 0.80 [0.67, 0.95]）的处方者遵守指南的可能性较低。遵守处方指南的用药方案能更好地控制血压（140.38（±18.98）/83.09（±11.02）mmHg，遵守处方指南的为 141.66（±19.86）/84.77（±11.71）mmHg，不遵守处方指南的为 141.66（±19.86）/84.77（±11.71）mmHg）：本研究强调了患者性别对处方者遵守降压处方指南的影响，并强调了在医疗保健领域存在的对女性系统性治疗不足的更大问题。需要进一步开展研究，以确定高血压护理中出现这种差异的原因。

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来源期刊

Pharmacoepidemiology and Drug Safety 医学-药学

CiteScore

4.80

自引率

7.70%

发文量

173

审稿时长

3 months

期刊介绍： The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report. Particular areas of interest include: design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology; comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world; methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology; assessments of harm versus benefit in drug therapy; patterns of drug utilization; relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines; evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.