eCite Digital Repository

Predictors of failure to initiate randomised treatment in a large-scale clinical trial of antihypertensive therapy in the aged

Citation

Nelson, MR and Reid, CM and Ryan, P and Willson, K and Beilin, LJ and Jennings, GL and Johnston, CI and Macdonald, GJ and Marley, JE and McNeil, JJ and Morgan, TO and West, MJ and Wing, LMH, Predictors of failure to initiate randomised treatment in a large-scale clinical trial of antihypertensive therapy in the aged, American Journal of Hypertension, 18, (6) pp. 885-888. ISSN 0895-7061 (2005) [Refereed Article]

DOI: doi:10.1016/j.amjhyper.2004.12.018

Abstract

Background: The identification of factors that contribute to noncompliance with trial drug initiation where virtually complete compliance might be expected, may help identify patients whose management is least likely to comply with clinical guidelines and study protocols. Methods: Examination of cross-sectional and longitudinal data arising from the Second Australian National Blood Pressure Study. Prevalence rate ratios (RR) and 95% confidence intervals (CI) estimated from log-binomial models were used to assess associations between subject characteristics and whether the randomized drug was prescribed at trial randomization. The study population consisted of 6083 hypertensive Australians aged 65 to 84 years. Results: After adjusting for each variable in a multivariate model the following were significant predictors of failure to prescribe RR (95% CI): not previously prescribed antihypertensive drugs 2.89 (2.52-3.32); lower systolic blood pressure (BP) 1.51 (1.59-1.43) or diastolic BP 1.18 (1.22-1.13); younger age 80 to 84 v 65 to 79 years 0.75 (0.59-0.95); total cholesterol ≥6.6 v ≤5.0 mmol/L 1.27 (1.06-1.53); and not ever having had a raised cholesterol 1.20 (1.04-1.40). There was no difference in cardiovascular disease end points and death in those who were and were not initiated on drug therapy at randomization. Conclusions: Failure to initiate antihypertensive therapy for patients at the randomization visit was associated with lower BP measurements, previous drug therapy, younger age, and a historic or current raised cholesterol, but not with overt cardiovascular disease or other risk factors. There was no difference in cardiovascular disease end points and death in those who were and were not initiated on drug therapy at randomization. © 2005 American Journal of Hypertension, Ltd.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Public Health and Health Services
Research Field:Health Information Systems (incl. Surveillance)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
Author:Nelson, MR (Professor Mark Nelson)
ID Code:35603
Year Published:2005
Deposited By:General Practice
Deposited On:2005-08-01
Last Modified:2006-03-27
Downloads:0

Repository Staff Only: item control page