| Nonadherence to angiotensinconverting enzyme inhibitors and/or angiotensin II receptor blockers among high-risk patients with diabetes in Medicare Part D programs. | |
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MedLine Citation:
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PMID: 20621872 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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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. |
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Authors:
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Yi Yang; Vennela Thumula; Patrick F Pace; Benjamin F Banahan; Noel E Wilkin; William B Lobb |
Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, Non-P.H.S. |
Journal Detail:
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Title: Journal of the American Pharmacists Association : JAPhA Volume: 50 ISSN: 1544-3450 ISO Abbreviation: J Am Pharm Assoc (2003) Publication Date: 2010 Jul-Aug |
Date Detail:
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Created Date: 2010-07-12 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101176252 Medline TA: J Am Pharm Assoc (2003) Country: United States |
Other Details:
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Languages: eng Pagination: 527-31 Citation Subset: IM |
Affiliation:
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School of Pharmacy, University of Mississippi, University, MS 38677, USA. yiyang@olemiss.edu |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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