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Compliance with antihypertensive therapy among elderly Medicaid enrollees: the roles of age, gender, and race.

M Monane, R L Bohn, J H Gurwitz, R J Glynn, R Levin and J Avorn

Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.

OBJECTIVES: This study measured compliance and related demographic factors in a retrospective cohort of 4068 elderly outpatients newly starting antihypertensive therapy from 1982 through 1988. METHODS: Logistic regression modeling of data from the New Jersey Medicaid program was used. RESULTS: These patients filled antihypertensive prescriptions covering an average of only 179 days in the 365-day follow-up period (49%) Good compliance (> or = 80%) was associated with advanced age (odds ratio [OR] = 2.12, for patients 85 or older) and White race (OR = 0.55 for Blacks). There was no relationship between compliance and gender. CONCLUSIONS: Despite the efficacy of antihypertensive therapy in preventing cardiovascular morbidity, such high rates of noncompliance may contribute to suboptimal patient outcomes.

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