Research Activities March 2013, No. 391
Disparities in adherence to blood pressure medications exist among older minorities
An important component of managing hypertension is for patients to adhere to their blood pressure medications. This is particularly important for blacks, for whom hypertension is more prevalent, uncontrolled, and associated with adverse outcomes. A new study found that medication adherence varied among a group of Medicare Part D beneficiaries, depending on patient factors, including race/ethnicity. Blacks had lower odds of adherence, as did other minorities, compared to whites. Medication adherence rates also differed from one geographic region to another.
Researchers reviewed claims data on 168,522 Medicare Part D enrollees with uncomplicated hypertension. Each had filled at least one prescription for blood pressure medication in 2006 and two prescriptions in 2007. The researchers looked at potential predictors of adherence that included age, sex, race/ethnicity, coexisting conditions, and other medications used. The overall adherence rate for blood pressure medications was 79.5 percent. Two classes of anti-hypertensive drugs were prescribed the most: beta blockers and diuretics. Blacks had the lowest rate of adherence (67.8 percent), followed by 69.3 percent for Hispanics and 81.5 percent for whites. There was a 47 percent lower odds of adherence for blacks and 42 percent lower odds of adherence for Hispanics compared with whites. Factors associated with lower adherence included having more coexisting conditions and using more medications. Given these findings, hypertensive patients with more coexisting conditions and concurrent medications are particularly vulnerable for adherence problems, note the researchers. They suggest targeting this group with individualized attention and programs to improve their levels of adherence. The study was supported in part by the Agency for Healthcare Research and Quality (HS17695).
See "Ethnic disparities in adherence to antihypertensive medications of Medicare Part D beneficiaries," by Holly M. Holmes, M.D., Ruili Luo, Ph.D., Joseph T. Hanlon, Pharm.D., M.S., and others in the July 2012 Journal of the American Geriatric Society 60(7), pp. 1298-1303.