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ORIGINAL RESEARCH article

Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1464689

Non-persistence with multiple secondary prevention medications for peripheral arterial disease among older hypertensive patients

Provisionally accepted
Martin Wawruch Martin Wawruch 1,2*Miriam Petrova Miriam Petrova 1,2Denisa Celovska Denisa Celovska 1,3*Sofa D. Alfian Sofa D. Alfian 4Tomas Tesar Tomas Tesar 5Jan Murin Jan Murin 3Michal Trnka Michal Trnka 1Tomas Paduch Tomas Paduch 6Emma Aarnio Emma Aarnio 7
  • 1 Faculty of Medicine, Comenius University, Bratislava, Slovakia
  • 2 Institute of Pharmacology and Clinical Pharmacology, Bratislava, Slovakia
  • 3 1st Department of Internal Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
  • 4 Padjadjaran University, Bandung, West Java, Indonesia
  • 5 Faculty of Pharmacy, Comenius University, Bratislava, Bratislava, Slovakia
  • 6 St. Anne's University Hospital Brno, Brno, South Moravia, Czechia
  • 7 University of Eastern Finland, Kuopio, Northern Savonia, Finland

The final, formatted version of the article will be published soon.

    The benefit of secondary prevention in hypertensive patients with peripheral arterial disease (PAD) is based on continual simultaneous taking of statins, antiplatelet agents and antihypertensive agents, preferably angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs). Our study was aimed at a) the analysis of the extent of non-persistence with multiple medication classes, and b) identifying factors associated with the likelihood of nonpersistence.In our cohort study, 3401 hypertensive patients (1853 females and 1548 males) aged ≥65 years treated simultaneously with statins, antiplatelet agents and ACEIs/ARBs and in whom PAD was newly diagnosed during 2012 were analysed. A patient was classified as non-persistent when he/she was non-persistent with at least one of the three analysed medication classes. The most important characteristics associated with the probability of non-persistence were identified using the Cox regression.Results: At the end of the follow-up period (mean length 1.8 years), 1869 (55.0%) patients (including 1090 females and 779 males) were classified as non-persistent. In the whole study cohort, factors associated with non-persistence were female sex, atrial fibrillation, and being a new user of at least one of the analysed medication classes; in males, they were university education, atrial fibrillation, and epilepsy, and, in females, being a new user.Identification of sex differences in factors associated with non-persistence makes it possible to determine the groups of patients in whom special attention should be paid to improving their persistence with a combination of medicines in order to ensure successful secondary prevention of PAD.

    Keywords: Peripheral Arterial Disease, Non-adherence, Non-persistence, New user, General practitioner, Statins, antiplatelet agents, Angiotensin-Converting Enzyme Inhibitors

    Received: 14 Jul 2024; Accepted: 01 Oct 2024.

    Copyright: © 2024 Wawruch, Petrova, Celovska, Alfian, Tesar, Murin, Trnka, Paduch and Aarnio. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Martin Wawruch, Faculty of Medicine, Comenius University, Bratislava, Slovakia
    Denisa Celovska, Faculty of Medicine, Comenius University, Bratislava, Slovakia

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.