Prescriber adherence to antihypertensive prescription guidelines and the impact of patient socioeconomic factors: a cross‐sectional study using data from the irish longitudinal study on ageing
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Date
2024
Authors
Akhtar, Alizeh
Burton, Edel
Bermingham, Margaret
Kearney, Patricia M.
Journal Title
Journal ISSN
Volume Title
Publisher
Wiley
Published Version
Abstract
Purpose
Uncontrolled hypertension causes significant morbidity and mortality worldwide. Several prescribing guidelines have been created to address this, however, prescriber adherence to guidelines is influenced by various sociodemographic patient factors. This study aims to determine the effects of these patient factors on prescriber adherence to antihypertensive prescription guidelines.
Methods
A secondary analysis of data from the first wave of The Irish Longitudinal Study on Ageing (TILDA), was conducted. Participants were included if they reported previous hypertension diagnoses. Antihypertensive medication regimes were compared with the prescribing guidance in the 2011 NICE hypertension guidelines. The effects of patient sociodemographic factors on prescriber adherence to guidelines, and the effect of prescriber adherence on blood pressure control (≥ 140/90 mmHg), were determined using binomial logistic regression models.
Results
A total of 2992 participants were included in this analysis; 54.9% female with mean age 65.7 years (±9.23). Male sex and older age, and lower socioeconomic status were associated with increased prescriber guideline adherence. Prescribers were less likely to adhere to guidelines in female patients ≥ 55 years (Relative Risk [RR] 0.75 [0.62, 0.91]), and female patients across all age groups (RR 0.80 [0.67, 0.95]). Better blood pressure control was seen with medication regimes adherent to prescription guidelines (140.38 (±18.98)/83.09 (±11.02) mmHg adherent vs. 141.66 (±19.86)/84.77 (±11.71) mmHg non-adherent).
Conclusions
This study highlights the effect of patient sex on prescriber adherence to antihypertensive prescription guidelines, emphasizing a larger issue of systemic undertreatment of females observed within healthcare. Further research is needed to determine the reasons for such differences in hypertensive care.
Description
Keywords
Antihypertensive agents , Guideline adherence , Hypertension , Prescribing , Sociodemographic factors
Citation
Akhtar, A., Burton, E., Bermingham, M. and Kearney, P.M. (2024) ‘Prescriber adherence to antihypertensive prescription guidelines and the impact of patient socioeconomic factors: a cross‐sectional study using data from the irish longitudinal study on ageing’, Pharmacoepidemiology and Drug Safety, 33(11), e70025 (12pp). https://doi.org/10.1002/pds.70025