gms | German Medical Science

14. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie

Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie

15.11. - 16.11.2007, Frankfurt am Main

Differences in persistence rates between various classes of antihypertensives in diabetic patients

Meeting Abstract

Suche in Medline nach

  • corresponding author K. Schüssel - DAPI - Verein Deutsches Arzneiprüfungsinstitut e. V., Eschborn, Germany
  • M. Schulz - DAPI - Verein Deutsches Arzneiprüfungsinstitut e. V., Eschborn, Germany

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie e.V. (GAA). 14. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie. Frankfurt am Main, 15.-16.11.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. Doc07gaa06

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Veröffentlicht: 12. November 2007

© 2007 Schüssel et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



Context: In the treatment of chronic diseases such as diabetes and cardiovascular diseases, lack of medication adherence represents a major factor limiting the potential benefits of pharmacotherapy (efficacy vs. effectiveness). The reasons for non-adherence are multifaceted but properties of the medication itself possibly play a considerable role.

Aim of the study: The aim of this study was to analyse possible differences in persistence rates between various classes of antihypertensive agents in diabetic patients and to identify factors modifying persistence.

Materials and methods: Data were extracted from the DAPI database, which contains anonymous, patient-individualised drug dispensing data (GKV) from more than 80% of German community pharmacies. The selected study population consisted of 15,070 insulin-dependent diabetic patients receiving antihypertensive agents over a period of at least 24 months during 2001 and 2003. Patients were defined as not persistent if the gap between two subsequent prescriptions exceeded the calculated medication supply by more than 3-fold, based on an assumed daily utilization of one DDD (defined daily dose).

Results: Persistence rates after 24 months were highest for AT1 antagonists (90.2%), followed by ACE inhibitors (82.2%) and calcium channel blockers (81.6%), whereas persistence was lower with diuretics (77.0%) and especially poor with betablockers (62.9%). In a Cox regression model, co-medication with further drugs indicative of a high cardiovascular risk profile (platelet aggregation inhibitors, coumarins, heparins) as well as co-prescriptions of blood glucose test strips, which may indicate self-management skills, were associated with a reduced risk for non-persistence.

Conclusions: These results – although not corrected for age, gender or specific disease state – suggest that antihypertensive drugs with favourable efficacy and safety profile may provide higher persistence with drug therapy. Modification by patient-individual factors such as cardiovascular co-morbidity and co-prescriptions for self-management of diabetes, implies that increasing risk awareness and improvement of patient skills may lead to higher persistence with antihypertensive drug therapy in diabetic patients.