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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, Gráinne

Authors

Paul Dillon

Derek Stewart

Susan M. Smith

Paul Gallagher

Gráinne Cousins



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.

Journal Article Type Article
Publication Date May 16, 2018
Journal Clinical pharmacology and therapeutics
Print ISSN 0009-9236
Electronic ISSN 1532-6535
Publisher New Publisher Required
Peer Reviewed Peer Reviewed
Volume 103
Issue 6
Pages 1052-1060
Institution 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
DOI https://doi.org/10.1002/cpt.865
Keywords Blood pressure; Adherence; Antihypertensive medication; GBTM

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