PMID- 20621872
OWN - NLM
STAT- MEDLINE
DCOM- 20101115
LR  - 20220321
IS  - 1544-3450 (Electronic)
IS  - 1086-5802 (Linking)
VI  - 50
IP  - 4
DP  - 2010 Jul-Aug
TI  - Nonadherence to angiotensin-converting enzyme inhibitors and/or angiotensin II 
      receptor blockers among high-risk patients with diabetes in Medicare Part D 
      programs.
PG  - 527-31
LID - 10.1331/JAPhA.2010.09071 [doi]
AB  - OBJECTIVES: To identify predictors of nonadherence to angiotensin-converting 
      enzyme inhibitors (ACEIs) and/or angiotensin II receptor blockers (ARBs) and to 
      assess the association between nonadherence to ACEIs/ARBs and potentially 
      avoidable hospitalizations (PAHs) among elderly high-risk patients with diabetes. 
      METHODS: Medicare Part D enrollees from six states who had diabetes and 
      coexisting hypertension and/or renal disease, were aged 65 years or older, and 
      who had filled at least one prescription for ACEIs/ARBs in the first 6 months of 
      2006 were included in this retrospective cohort study. The primary outcomes of 
      interests were patient nonadherence to ACEI/ARB therapy, which was defined as a 
      proportion of days covered (PDC) less than 0.8 and PAH for diabetes during the 
      patient follow-up period (July 1, 2006, to March 31, 2007). RESULTS: A total of 
      599,141 patients (mean [+/-SD] age 75.6 +/-7.3 years, 66% women, 63% white, 15% 
      black, and 9% Hispanic) were included. Among them, 46% were nonadherent to 
      ACEI/ARB therapy and 6.3% had a PAH during the follow-up period. In multivariate 
      logistic regressions, patients with diabetes and both hypertension and renal 
      disease and patients with diabetes and renal disease only were 24% and 15% more 
      likely, respectively, to be nonadherent to ACEI/ARB therapy compared with 
      patients with diabetes and hypertension. Black and Hispanic patients were also 
      more likely to be nonadherent to ACEI/ARB therapy. Nonadherence to ACEI/ARB 
      therapy was associated with a 5% increase in the likelihood of PAH. CONCLUSION: 
      Adherence to ACEI/ARB therapy is suboptimal among elderly high-risk patients with 
      diabetes enrolled in Medicare Part D programs from six states, and nonadherence 
      to ACEIs/ARBs is associated with a slightly increased risk for PAH.
FAU - Yang, Yi
AU  - Yang Y
AD  - School of Pharmacy, University of Mississippi, University, MS 38677, USA. 
      yiyang@olemiss.edu
FAU - Thumula, Vennela
AU  - Thumula V
FAU - Pace, Patrick F
AU  - Pace PF
FAU - Banahan, Benjamin F 3rd
AU  - Banahan BF 3rd
FAU - Wilkin, Noel E
AU  - Wilkin NE
FAU - Lobb, William B
AU  - Lobb WB
LA  - eng
PT  - Journal Article
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PL  - United States
TA  - J Am Pharm Assoc (2003)
JT  - Journal of the American Pharmacists Association : JAPhA
JID - 101176252
RN  - 0 (Angiotensin II Type 1 Receptor Blockers)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Antihypertensive Agents)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Angiotensin II Type 1 Receptor Blockers/*therapeutic use
MH  - Angiotensin-Converting Enzyme Inhibitors/*therapeutic use
MH  - Antihypertensive Agents/therapeutic use
MH  - *Diabetes Complications
MH  - Drug Therapy, Combination
MH  - Female
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Hypertension/*complications/*drug therapy
MH  - Male
MH  - *Medicare Part D
MH  - Medication Adherence/*statistics & numerical data
MH  - United States
EDAT- 2010/07/14 06:00
MHDA- 2010/11/16 06:00
CRDT- 2010/07/13 06:00
PHST- 2010/07/13 06:00 [entrez]
PHST- 2010/07/14 06:00 [pubmed]
PHST- 2010/11/16 06:00 [medline]
AID - S1544-3191(15)30849-9 [pii]
AID - 10.1331/JAPhA.2010.09071 [doi]
PST - ppublish
SO  - J Am Pharm Assoc (2003). 2010 Jul-Aug;50(4):527-31. doi: 
      10.1331/JAPhA.2010.09071.