{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T13:08:57Z","timestamp":1793365737501,"version":"4.5.0"},"reference-count":24,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi221352-4\"><jats:title>Importance<\/jats:title><jats:p>Adherence to selected antihypertensive medications (proportion of days covered [PDC]) declined after guidance to shelter in place for COVID-19.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi221352-5\"><jats:title>Objectives<\/jats:title><jats:p>To determine whether PDC for all antihypertensive medications collectively fell from the 6 months before sheltering guidance (September 15, 2019, to March 14, 2020 [baseline]) compared with the first (March 15 to June 14, 2020) and second (June 15 to September 14, 2020) 3 months of sheltering and to assess the usefulness of baseline PDC for identifying individuals at risk for declining PDC during sheltering.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi221352-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This retrospective cohort study included a random sample of US adults obtained from EagleForce Health, a division of EagleForce Associates Inc. Approximately one-half of the adults were aged 40 to 64 years and one-half were aged 65 to 90 years, with prescription drug coverage, hypertension, and at least 1 antihypertensive medication prescription filled at a retail pharmacy during baseline.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi221352-7\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Prescription claims were used to assess (1) PDC at baseline and changes in PDC during the first and second 3 months of sheltering and (2) the association of good (PDC\u2009\u2265\u200980), fair (PDC 50-79), and poor (PDC &amp;amp;lt; 50) baseline adherence with adherence during sheltering.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi221352-8\"><jats:title>Results<\/jats:title><jats:p>A total of 27\u202f318 adults met inclusion criteria (mean [SD] age, 65.0 [11.7] years; 50.7% women). Mean PDC declined from baseline (65.6 [95% CI, 65.2-65.9]) during the first (63.4 [95% CI, 63.0-63.8]) and second (58.9 [95% CI, 58.5-59.3]) 3 months after sheltering in all adults combined (<jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001 for both comparisons) and both age groups separately. Good, fair, and poor baseline adherence was observed in 40.0%, 27.8%, and 32.2% of adults, respectively. During the last 3 months of sheltering, PDC declined more from baseline in those with good compared with fair baseline adherence (\u221213.1 [95% CI, \u221213.6 to \u221212.6] vs \u22128.3 [95% CI, \u221213.6 to \u221212.6]; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001), whereas mean (SD) PDC increased in those with poor baseline adherence (mean PDC, 31.6 [95% CI, 31.3-31.9] vs 34.4 [95% CI, 33.8-35.0]; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001). However, poor adherence during sheltering occurred in 1034 adults (9.5%) with good baseline adherence, 2395 (31.6%) with fair baseline adherence, and 6409 (72.9%) with poor baseline adherence.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi221352-9\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>These findings suggest that individuals with poor baseline adherence are candidates for adherence-promoting interventions irrespective of sheltering guidance. Interventions to prevent poor adherence during sheltering may be more useful for individuals with fair vs good baseline adherence.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.47787","type":"journal-article","created":{"date-parts":[[2022,12,20]],"date-time":"2022-12-20T16:01:44Z","timestamp":1671552104000},"page":"e2247787","source":"Crossref","is-referenced-by-count":16,"title":["Association of Baseline Adherence to Antihypertensive Medications With Adherence After Shelter-in-Place Guidance for COVID-19 Among US Adults"],"prefix":"10.1001","volume":"5","author":[{"given":"Brent M.","family":"Egan","sequence":"first","affiliation":[{"name":"Improving Health Outcomes, American Medical Association, Greenville, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan E.","family":"Sutherland","sequence":"additional","affiliation":[{"name":"Improving Health Outcomes, American Medical Association, Greenville, South 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