Non-persistence with multiple secondary prevention medications for peripheral arterial disease among older hypertensive patients

IntroductionThe benefit of secondary prevention in hypertensive patients with peripheral arterial disease (PAD) is based on continual simultaneous taking of statins, antiplatelet agents and antihypertensive agents, preferably angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor b...

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Main Authors: Martin Wawruch, Miriam Petrova, Denisa Celovska, Sofa D. Alfian, Tomas Tesar, Jan Murin, Michal Trnka, Tomas Paduch, Emma Aarnio
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Pharmacology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2024.1464689/full
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author Martin Wawruch
Miriam Petrova
Denisa Celovska
Sofa D. Alfian
Sofa D. Alfian
Tomas Tesar
Jan Murin
Michal Trnka
Tomas Paduch
Emma Aarnio
author_facet Martin Wawruch
Miriam Petrova
Denisa Celovska
Sofa D. Alfian
Sofa D. Alfian
Tomas Tesar
Jan Murin
Michal Trnka
Tomas Paduch
Emma Aarnio
author_sort Martin Wawruch
collection DOAJ
description IntroductionThe benefit of secondary prevention in hypertensive patients with peripheral arterial disease (PAD) is based on continual simultaneous taking of statins, antiplatelet agents and antihypertensive agents, preferably angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs). Our study was aimed at a) the analysis of the extent of non-persistence with multiple medication classes, and b) identifying factors associated with the likelihood of non-persistence.MethodsIn our cohort study, 3,401 hypertensive patients (1,853 females and 1,548 males) aged ≥65 years treated simultaneously with statins, antiplatelet agents and ACEIs/ARBs and in whom PAD was newly diagnosed during 2012 were analysed. A patient was classified as non-persistent when he/she was non-persistent with at least one of the three analysed medication classes. The most important characteristics associated with the probability of non-persistence were identified using the Cox regression.ResultsAt the end of the follow-up period (mean length 1.8 years), 1,869 (55.0%) patients (including 1,090 females and 779 males) were classified as non-persistent. In the whole study cohort, factors associated with non-persistence were female sex, atrial fibrillation, and being a new user of at least one of the analysed medication classes; in males, they were university education, atrial fibrillation, and epilepsy, and, in females, being a new user.ConclusionIdentification of sex differences in factors associated with non-persistence makes it possible to determine the groups of patients in whom special attention should be paid to improving their persistence with a combination of medicines in order to ensure successful secondary prevention of PAD.
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spelling doaj-art-e5f2835ce8904ae3b955cf150ddee5d02025-08-20T01:58:12ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122024-12-011510.3389/fphar.2024.14646891464689Non-persistence with multiple secondary prevention medications for peripheral arterial disease among older hypertensive patientsMartin Wawruch0Miriam Petrova1Denisa Celovska2Sofa D. Alfian3Sofa D. Alfian4Tomas Tesar5Jan Murin6Michal Trnka7Tomas Paduch8Emma Aarnio9Institute of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Comenius University, Bratislava, SlovakiaInstitute of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Comenius University, Bratislava, SlovakiaDepartment of Internal Medicine, Faculty of Medicine, Comenius University, Bratislava, SlovakiaDepartment of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, IndonesiaCenter of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, IndonesiaDepartment of Organisation and Management of Pharmacy, Faculty of Pharmacy, Comenius University, Bratislava, SlovakiaDepartment of Internal Medicine, Faculty of Medicine, Comenius University, Bratislava, SlovakiaInstitute of Medical Physics and Biophysics, Faculty of Medicine, Comenius University, Bratislava, Slovakia2nd Department of Surgery, Center for Vascular Disease, St. Anne’s University Hospital and Faculty of Medicine, Masaryk University, Brno, CzechiaSchool of Pharmacy, University of Eastern Finland, Kuopio, FinlandIntroductionThe benefit of secondary prevention in hypertensive patients with peripheral arterial disease (PAD) is based on continual simultaneous taking of statins, antiplatelet agents and antihypertensive agents, preferably angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs). Our study was aimed at a) the analysis of the extent of non-persistence with multiple medication classes, and b) identifying factors associated with the likelihood of non-persistence.MethodsIn our cohort study, 3,401 hypertensive patients (1,853 females and 1,548 males) aged ≥65 years treated simultaneously with statins, antiplatelet agents and ACEIs/ARBs and in whom PAD was newly diagnosed during 2012 were analysed. A patient was classified as non-persistent when he/she was non-persistent with at least one of the three analysed medication classes. The most important characteristics associated with the probability of non-persistence were identified using the Cox regression.ResultsAt the end of the follow-up period (mean length 1.8 years), 1,869 (55.0%) patients (including 1,090 females and 779 males) were classified as non-persistent. In the whole study cohort, factors associated with non-persistence were female sex, atrial fibrillation, and being a new user of at least one of the analysed medication classes; in males, they were university education, atrial fibrillation, and epilepsy, and, in females, being a new user.ConclusionIdentification of sex differences in factors associated with non-persistence makes it possible to determine the groups of patients in whom special attention should be paid to improving their persistence with a combination of medicines in order to ensure successful secondary prevention of PAD.https://www.frontiersin.org/articles/10.3389/fphar.2024.1464689/fullperipheral arterial diseasenon-adherencenon-persistencenew usergeneral practitionerstatins
spellingShingle Martin Wawruch
Miriam Petrova
Denisa Celovska
Sofa D. Alfian
Sofa D. Alfian
Tomas Tesar
Jan Murin
Michal Trnka
Tomas Paduch
Emma Aarnio
Non-persistence with multiple secondary prevention medications for peripheral arterial disease among older hypertensive patients
Frontiers in Pharmacology
peripheral arterial disease
non-adherence
non-persistence
new user
general practitioner
statins
title Non-persistence with multiple secondary prevention medications for peripheral arterial disease among older hypertensive patients
title_full Non-persistence with multiple secondary prevention medications for peripheral arterial disease among older hypertensive patients
title_fullStr Non-persistence with multiple secondary prevention medications for peripheral arterial disease among older hypertensive patients
title_full_unstemmed Non-persistence with multiple secondary prevention medications for peripheral arterial disease among older hypertensive patients
title_short Non-persistence with multiple secondary prevention medications for peripheral arterial disease among older hypertensive patients
title_sort non persistence with multiple secondary prevention medications for peripheral arterial disease among older hypertensive patients
topic peripheral arterial disease
non-adherence
non-persistence
new user
general practitioner
statins
url https://www.frontiersin.org/articles/10.3389/fphar.2024.1464689/full
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