Group-based trajectory models: assessing adherence to antihypertensive medication in older adults in a community pharmacy setting.

Dillon, Paul; Stewart, Derek; Smith, Susan M.; Gallagher, Paul; Cousins, Gr�inne

Abstract

Antihypertensive medication nonadherence is highly prevalent, leading to uncontrolled blood pressure. Methods that facilitate the targeting and tailoring of adherence interventions in clinical settings are required. Group-Based Trajectory Modeling (GBTM) is a newer method to evaluate adherence using pharmacy dispensing (refill) data that has advantages over traditional refill adherence metrics (e.g. Proportion of Days Covered) by identifying groups of patients who may benefit from adherence interventions, and identifying patterns of adherence behavior over time that may facilitate tailoring of an adherence intervention. We evaluated adherence to antihypertensive medication in 905 patients over a 12-month period in a community pharmacy setting using GBTM, identifying three subgroups of adherence patterns: 52.8%, 40.7%, and 6.5% had very high, high, and low adherence, respectively. However, GBTM failed to demonstrate predictive validity with blood pressure at 12 months. Further research on the validity of adherence measures that facilitate interventions in clinical settings is required.

Citation

DILLON, P., STEWART, D., SMITH, S.M., GALLAGHER, P. and COUSINS, G. 2018. Group-based trajectory models: assessing adherence to antihypertensive medication in older adults in a community pharmacy setting. Clinical pharmacology and therapeutics [online], 103(6), pages 1052-1060. Available from: https://doi.org/10.1002/cpt.865

• Journal Article Type: Article
• Acceptance Date: Aug 27, 2017
• Online Publication Date: Sep 5, 2017
• Publication Date: Jun 30, 2018
• Deposit Date: Jun 4, 2018
• Publicly Available Date: Jun 4, 2018
• Journal: Clinical pharmacology and therapeutics
• Print ISSN: 0009-9236
• Electronic ISSN: 1532-6535
• Publisher: American Society for Clinical Pharmacology and Therapeutics
• Peer Reviewed: Peer Reviewed
• Volume: 103
• Issue: 6
• Pages: 1052-1060
• DOI: https://doi.org/10.1002/cpt.865
• Keywords: Blood pressure; Adherence; Antihypertensive medication; GBTM
• Public URL: http://hdl.handle.net/10059/2941
• Contract Date: Jun 4, 2018