DISCONTINUATION OF AND CHANGES IN TREATMENT AFTER START OF NEW COURSES OF ANTIHYPERTENSIVE DRUGS - A STUDY OF A UNITED-KINGDOM POPULATION

Objective-To evaluate the incidence of discontinuation of and changes in treatment after newly prescribed courses of antihypertensive drugs of the four primary therapeutic classes: beta blocker, calcium channel blocker, and angiotensin converting enzyme inhibitor. Design-A retros pective analysis of patients on an automated database of 1.2 million p atients was conducted on visits between 1 October 1992 and 30 Septembe r 1993. Setting-General practices in the United Kingdom. Subjects-37 6 43 patients with hypertension receiving a relevant drug in the time pe riod were identified. A new course of treatment in at least one of the four therapeutic classes, defined as a drug not prescribed in the pre vious four months, was observed in 10 222 patients aged greater than o r equal to 40 years. Main outcome measures-Patients changing to other treatment or discontinuing after initiating a new course of treatment, defined as the absence of a refill prescription for the new drug or a nother in its category within a six month observation period. Results- Changes in or discontinuation of treatment were frequently observed, a nd by month six continuation rates ranged between 40% to 50% for all f our classes of drugs. Conclusion-Low rates of continuation with a newl y prescribed antihypertensive drug exist regardless of which drug is p rescribed.