{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T16:32:36Z","timestamp":1759336356703,"version":"3.40.5"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,2,19]],"date-time":"2019-02-19T00:00:00Z","timestamp":1550534400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Poor adherence and persistence to blood pressure lowering (BPL) agents leads to increased risk of morbidity and mortality. The aim of this study was to investigate the long\u2010term adherence, persistence, and re\u2010initiation of BPL agents among older Australians (aged \u226565\u00a0years).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We utilised the Pharmaceutical Benefits Scheme data covering a 10% random sample of Australians. We identified 31\u00a0088 older Australians (mean age, 75.4\u00a0years; 56% females) with newly initiated BPL therapy from 2008 to 2016. Adherence was assessed using the proportion of days covered (PDC) at 6\u2010month intervals. Discontinuation was defined as \u226590\u00a0days without BPL coverage. Cox regression was applied to compare the time till the first discontinuation of BPL agents across different BPL categories and among various subgroups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over a mean follow\u2010up of 3.8\u00a0years, 40% to 70% of older Australians received a BPL agent discontinued it. The median time to discontinuation ranged from 159 to 373\u00a0days. Persistence with fixed dose combinations was the best (68%, 58%, and 41% at 6, 12, and 36\u00a0months respectively), followed by angiotensin II receptor blockers (69%, 58%, and 40%), beta\u2010blockers (67%, 54%, and 36%), angiotensin converting enzyme inhibitors (62%, 51%, and 34%), calcium channel blockers (57%, 47%, and 31%), and diuretics (59%, 41%, and 23%). Among those who discontinued, 30% to 50% re\u2010initiated, with median days to re\u2010initiation ranging from 177 to 302. Only 21% to 42% of the study population maintained \u201cgood\u201d adherence (PDC\u00a0\u2265\u00a00.8) to BPLs over 3\u00a0years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compliance to BPL agents is poor among older Australians. Interventions to enhance adherence and persistence to BPL agents are needed.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.4742","type":"journal-article","created":{"date-parts":[[2019,2,20]],"date-time":"2019-02-20T01:15:10Z","timestamp":1550625310000},"page":"788-795","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Long\u2010term persistence and adherence to blood pressure lowering agents among older Australians"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2406-7221","authenticated-orcid":false,"given":"Si","family":"Si","sequence":"first","affiliation":[{"name":"Centre of Cardiovascular Research and Education in Therapeutics, Department of Public Health and Preventive Medicine Monash University  Melbourne Australia"},{"name":"NHMRC Centre of Research Excellence in Cardiovascular Outcomes Improvement Curtin University  Perth 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