{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T13:08:27Z","timestamp":1791464907637,"version":"4.3.4"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Medication non\u2010adherence can result in considerable morbidity, mortality, and costs. The Pharmacy Quality Alliance hypertension medication adherence measure is used by US healthcare payers and providers to assess renin\u2010angiotensin system antagonist medication adherence. However, associations between renin\u2010angiotensin system antagonist adherence as calculated in quality measures, and healthcare service use and expenditure in commercial populations over a 1\u2010year timeframe has not been assessed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">This retrospective cohort study used eligible commercially insured individuals from the Truven Health MarketScan Commercial Claims and Encounters Research Databases (2009\u20132015). Generalized linear models with log link and gamma distribution (expenditure) or negative binomial distribution (usage) assessed relationships between hypertension adherence (\u226580% proportion of days covered) and healthcare use and expenditures (in 2015 US dollars) while adjusting for covariates (age, sex, geographic region; health plan; Deyo\u2010Charlson Comorbidity Index, number of chronic medications, and treatment naivety). Beta coefficients were used to compute cost ratios and rate ratios. A total of 4\u200a842\u2009058 subjects were eligible; of those, 3\u00a0310\u00a0360 (68%) were adherent (adherent mean age 53.3\u00b18.0\u00a0years, 55.9% men; non\u2010adherent mean age 50.3\u00b19.1\u00a0years, 53.1% men). Adherence was associated with fewer inpatient (rate ratios, 0.612; 95% CI, 0.607\u20130.617) and outpatient visits (rate ratios, 0.995; 95% CI, 0.994\u20130.997); and lower total costs (cost ratios, 0.876; 95% CI, 0.874\u20130.878) compared with non\u2010adherence. Adherence was associated with lower average per member per month total costs ($97.98) compared with non\u2010adherence.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Adherence to renin\u2010angiotensin system antagonists was associated with fewer outpatient and inpatient visits, and lower total costs compared with non\u2010adherence in a 1\u2010year time frame.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.016094","type":"journal-article","created":{"date-parts":[[2020,8,26]],"date-time":"2020-08-26T09:19:57Z","timestamp":1598433597000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Associations of Renin\u2010Angiotensin System Antagonist Medication Adherence and Economic Outcomes Among Commercially Insured US Adults: A Retrospective Cohort Study"],"prefix":"10.1161","volume":"9","author":[{"given":"Patrick J.","family":"Campbell","sequence":"first","affiliation":[{"name":"College of Pharmacy University of Arizona Tucson AZ"},{"name":"Pharmacy Quality Alliance, Inc. Alexandria VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9903-5996","authenticated-orcid":false,"given":"David R.","family":"Axon","sequence":"additional","affiliation":[{"name":"College of Pharmacy University of Arizona Tucson AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann M.","family":"Taylor","sequence":"additional","affiliation":[{"name":"College of Pharmacy University of Arizona Tucson AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Pickering","sequence":"additional","affiliation":[{"name":"Pharmacy Quality Alliance, Inc. Alexandria VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4739-3572","authenticated-orcid":false,"given":"Heather","family":"Black","sequence":"additional","affiliation":[{"name":"Merck &amp; Co., Inc. Kenilworth NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terri","family":"Warholak","sequence":"additional","affiliation":[{"name":"College of Pharmacy University of Arizona Tucson AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanadda","family":"Chinthammit","sequence":"additional","affiliation":[{"name":"College of Pharmacy University of Arizona Tucson AZ"},{"name":"Eli Lilly and Company Indianapolis IN"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.19043"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61766-8"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31679-8"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000485"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60685-1"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1511939"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.11.006"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2018.14"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra050100"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.4065\/mcp.2010.0575"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.768986"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-200209000-00009"},{"key":"e_1_3_2_14_2","unstructured":"Pharmacy Quality Alliance . 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