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412: Persistence and adherence to hypolipemic therapy in real practice: Results of a large administrative database
Journal of Clinical Lipidology, Vol 2, No 5S, October 2008
could be an effective method to optimize IWG in HD patients and thereby to reduce ultrafiltration and systolic blood pressure. Hospitalization and diastolic hypotension could be prevented. Funding: The study was supported by Roche Pharma
Conclusions: Persistent and adherence with hypolipemic medications is far from optimal in this large cohort of subjects. This phenomenon is common to many asymptomatic chronic therapies and deserves further investigations, as it indicates that a relevant part of drug resources are spent without a predictable clinical benefit. Funding: none
412 PERSISTENCE AND ADHERENCE TO HYPOLIPEMIC THERAPY IN REAL PRACTICE: RESULTS OF A LARGE ADMINISTRATIVE DATABASE L.G. Mantovani1, C. Fornari2, F. Madotto2, V. Chiodini2, G. Veronesi3, M. Ferrario3, G. Cesana2. 1Federico II University of Naples, Naples, Italy, 2University of Milano-Bicocca, Monza, Italy, 3University of Insubria, Varese, Italy Rationale: Chronic disease therapies have to be taken for long periods and low compliance/ persistence may compromise the potential benefits of treatment. Objective: To investigate patients’ adherence and persistence to therapy with hypolipemic medications using a large administrative database. Methods We used the Regione Lombardia Health Service (RLHS) administrative databases, which contain information on a population of >9 millions individuals with universal healthcare and pharmaceutical coverage. Persistence and adherence was evaluated with the medication possession ratio (MPR), calculated as the ratio between the number of pills dispensed during the study period and the number of days of observation. Results: Out of a population of 9,108,645 members, 560,737 (6.2%) received at least one prescription of a study drug. Frequency of use increased from 0.7% in subjects with age <40 years to 18.4% in subjects age 70-79 y.o.. 16.2% of subjects received one or two packs during the study period, the median number of packs prescribed was 14, and simvastatin (35.4%), atorvastatin (27.6%) and pravastatin (13.2%) were the most prescribed initial drugs. 503,023 patients were considered for the adherence analysis: 34.9% of subjects had MPR<0.4; 34.7% between 0.4 and 0.8 ; and 30.4%>0.8.
413 EDUCATIONAL PREVENTIVE TECHNOLOGY FOR PATIENTS WITH HYPERTENSION (CLINIC EFFICIENCY AND COST-EFFECTIVENESS ANALYSIS) A. Kontsevaya, A. Kalinina. National Research Center for Preventive Medicine, Moscow, Russia Objective: To study clinic and economic efficiency of structured education program for hypertensive patients Methods: The study involved 303 hypertensive patients without serious complications. These patients were randomized to treatment and control group. Patients of treatment group participated in structured education program and patients of control group were in routine clinic All patients were observed during 12 months. Parameters of clinic efficiency included arterial pressure, cholesterol, left ventricle hypertrophy (LVG) and cardiovascular risk reduction and quality of life (SF-36). Economic efficiency was evaluated on the basis of cost of illness and costeffectiveness analysis. Results: All clinic and economic parameters were fixed one year after patient education. The proportion of patient with arterial pressure >140/90 mm Hg was 68% in treatment group and 12% in control group (p<0,05). Average cholesterol levels were 5,9 mmol/L in treatment group and 6,9 mmol/L in control group (p<0,05). The proportion of patient with high cardiovascular risk was 79,7% in treatment group and 62% in control group (p<0,05). Also in treatment group proportion of patients with LVG decreased on 15% and didn’t change in control group (p<0,05). In treatment group quality of life significantly increased during evaluation period. The cost-efficiency ratio for decreasing arterial pressure on 1% was 216,6$ in treatment group and 1179$ in control group. Conclusion: Structured education for
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could be an effective method to optimize IWG in HD patients and thereby to reduce ultrafiltration and systolic blood pressure. Hospitalization and diastolic hypotension could be prevented. Funding: The study was supported by Roche Pharma
Conclusions: Persistent and adherence with hypolipemic medications is far from optimal in this large cohort of subjects. This phenomenon is common to many asymptomatic chronic therapies and deserves further investigations, as it indicates that a relevant part of drug resources are spent without a predictable clinical benefit. Funding: none
412 PERSISTENCE AND ADHERENCE TO HYPOLIPEMIC THERAPY IN REAL PRACTICE: RESULTS OF A LARGE ADMINISTRATIVE DATABASE L.G. Mantovani1, C. Fornari2, F. Madotto2, V. Chiodini2, G. Veronesi3, M. Ferrario3, G. Cesana2. 1Federico II University of Naples, Naples, Italy, 2University of Milano-Bicocca, Monza, Italy, 3University of Insubria, Varese, Italy Rationale: Chronic disease therapies have to be taken for long periods and low compliance/ persistence may compromise the potential benefits of treatment. Objective: To investigate patients’ adherence and persistence to therapy with hypolipemic medications using a large administrative database. Methods We used the Regione Lombardia Health Service (RLHS) administrative databases, which contain information on a population of >9 millions individuals with universal healthcare and pharmaceutical coverage. Persistence and adherence was evaluated with the medication possession ratio (MPR), calculated as the ratio between the number of pills dispensed during the study period and the number of days of observation. Results: Out of a population of 9,108,645 members, 560,737 (6.2%) received at least one prescription of a study drug. Frequency of use increased from 0.7% in subjects with age <40 years to 18.4% in subjects age 70-79 y.o.. 16.2% of subjects received one or two packs during the study period, the median number of packs prescribed was 14, and simvastatin (35.4%), atorvastatin (27.6%) and pravastatin (13.2%) were the most prescribed initial drugs. 503,023 patients were considered for the adherence analysis: 34.9% of subjects had MPR<0.4; 34.7% between 0.4 and 0.8 ; and 30.4%>0.8.
413 EDUCATIONAL PREVENTIVE TECHNOLOGY FOR PATIENTS WITH HYPERTENSION (CLINIC EFFICIENCY AND COST-EFFECTIVENESS ANALYSIS) A. Kontsevaya, A. Kalinina. National Research Center for Preventive Medicine, Moscow, Russia Objective: To study clinic and economic efficiency of structured education program for hypertensive patients Methods: The study involved 303 hypertensive patients without serious complications. These patients were randomized to treatment and control group. Patients of treatment group participated in structured education program and patients of control group were in routine clinic All patients were observed during 12 months. Parameters of clinic efficiency included arterial pressure, cholesterol, left ventricle hypertrophy (LVG) and cardiovascular risk reduction and quality of life (SF-36). Economic efficiency was evaluated on the basis of cost of illness and costeffectiveness analysis. Results: All clinic and economic parameters were fixed one year after patient education. The proportion of patient with arterial pressure >140/90 mm Hg was 68% in treatment group and 12% in control group (p<0,05). Average cholesterol levels were 5,9 mmol/L in treatment group and 6,9 mmol/L in control group (p<0,05). The proportion of patient with high cardiovascular risk was 79,7% in treatment group and 62% in control group (p<0,05). Also in treatment group proportion of patients with LVG decreased on 15% and didn’t change in control group (p<0,05). In treatment group quality of life significantly increased during evaluation period. The cost-efficiency ratio for decreasing arterial pressure on 1% was 216,6$ in treatment group and 1179$ in control group. Conclusion: Structured education for
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