Individuals at risk of beta-blocker discontinuation: a cohort study in 19,177 Chinese patients

Wong, M. C.S., Jiang, J. Y., Su, X., Wang, H. H.X. , Tang, J. L. and Griffiths, S. M. (2010) Individuals at risk of beta-blocker discontinuation: a cohort study in 19,177 Chinese patients. Clinical Research in Cardiology, 99(5), pp. 277-284. (doi: 10.1007/s00392-010-0114-1) (PMID:20174812)

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Abstract

Purpose: This cohort study evaluated the factors associated with discontinuation of antihypertensive pharmacotherapy among Chinese patients who were prescribed beta-blockers. We tested the hypothesis that patients’ age, gender, socioeconomic status, clinical settings and the number of comorbidities were significantly associated with the discontinuation of beta-blockers. Methods: From a validated clinical database we included all adult patients 18 years or older who were prescribed a beta-blocker in any government primary care clinic in one large territory of Hong Kong during 01 January 2004–30 June 2007. We evaluated the cumulative incidence of drug discontinuation within 180 days of the prescriptions and the factors associated with discontinuation of beta-blockers by multivariable regression analysis. Results: From a total of 19,177 eligible patients (mean age = 59.1 years), 20.8% discontinued their medication. Younger patients [aged <50 years; adjusted odds ratios (aOR) 0.41–0.52 for patients aged ≥50 years; p < 0.001], female gender (aOR 0.87 for males, p = 0.001), fee-waivers (aOR 0.78 for fee-payers, p < 0.001), attendances in family medicine specialist clinics (FMSC) (aOR 1.49, p < 0.001) and staff clinics (aOR 2.32, p < 0.001), residence in more urbanized areas (aOR 0.80 for North District, p < 0.001), new visits (aOR 0.55 for follow-up visits, p < 0.001) and absence of concomitant comorbidities (aOR 0.60 for one comorbidity, p < 0.001; aOR 0.56 for two comorbidities, p = 0.002) were positively associated with drug discontinuation. Conclusions: Patients who were prescribed beta-blockers with these associated factors should be monitored more closely for antihypertensive drug adherence.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Wang, Professor Haoxiang
Authors: Wong, M. C.S., Jiang, J. Y., Su, X., Wang, H. H.X., Tang, J. L., and Griffiths, S. M.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
Journal Name:Clinical Research in Cardiology
Publisher:Springer
ISSN:1861-0684
ISSN (Online):1861-0692
Published Online:21 February 2010

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