EFFECT OF PHARMACEUTICAL FORMULATION FOR ANTIHYPERTENSIVE THERAPY ON HEALTH-SERVICE UTILIZATION

A significant factor in the management of hypertension is the extent t o which patients comply with the treatment regimen. A retrospective an alysis was undertaken to determine the relationship between antihypert ensive formulation, regimen compliance, and the utilization of health care services. Data for this analysis were derived from the state of S outh Carolina's Medicaid computer archive. The study population consis ted of 1000 randomly selected patients initially prescribed one of the following antihypertensive regimens as monotherapy: atenolol once dai ly, captopril BID, oral clonidine BID, transdermal clonidine once week ly, diltiazem BID, enalapril BID, metoprolol BID, prazosin BID, terazo sin once daily, and sustained-release verapamil once daily. Multivaria te regression analysis was used to determine the incremental influence of selected demographic characteristics, use of medical services befo re diagnosis of hypertension, initial antihypertensive medication, med ication possession ratio for antihypertensive therapy, and number of m aintenance medications for diseases other than hypertension on post-pe riod health care expenditures. The results indicated that patients ini tially prescribed antihypertensive medication requiring once-daily or once-weekly administration experienced an increased utilization of ant ihypertensive medication, needed fewer changes in their therapeutic re gimen, and far less need for concomitant therapy for blood pressure co ntrol compared with those prescribed a BID regimen. Patients in the on ce-daily or once-weekly groups also used significantly fewer physician , hospital, and laboratory services (P less-than-or-equal-to 0.05).