Initial Antihypertensive Prescribing in Relation to Blood Pressure Among Florida Medicaid and Medicare Recipients in the OneFlorida+ Research Consortium.
Initial Antihypertensive Prescribing in Relation to Blood Pressure Among Florida Medicaid and Medicare Recipients in the OneFlorida+ Research Consortium.
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OneFlorida 研究联盟的佛罗里达州医疗补助和医疗保险接受者中与血压相关的初始抗高血压处方。
DOI：
10.1161/hypertensionaha.123.21901
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Smith,StevenM
中科院分区：
文献类型：
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作者：
Smith,KaylaM;Keshwani,Shailina;Walsh,MartaG;Winterstein,AlmutG;Gurka,MatthewJ;Libby,Anne;Hogan,WilliamR;Pepine,CarlJ;Cooper-DeHoff,RhondaM;Smith,StevenM
对于新诊断的高血压患者，早期有效的抗高血压治疗可获得更好的结局。现行指南建议2期高血压（血压[BP]≥ 140/90 mm Hg）患者开始联合治疗，使用≥ 2种药物。1然而，很少有真实世界的研究在基线BP的背景下评估初始抗高血压治疗。2因此，我们在OneFlorida+研究联盟（以下简称OneFlorida+）中检查了医疗补助和医疗保险接受者的初始抗高血压治疗模式，这些接受者具有相关的索赔和电子健康记录（EHR）。我们使用先前描述的医疗保险和医疗补助保险的高血压成年人（年龄≥ 18岁）队列进行了一项横断面研究，这些人是2012年至2021年的新抗高血压使用者。3医疗补助接受者是主要低收入的佛罗里达州成年人，医疗保险接受者是年龄≥ 65岁或有资格残疾的佛罗里达州成年人，在研究期间有A、B和D部分。从该队列中，我们将人群限制为从假定处方访视开始在OneFlorida+中具有关联门诊EHR的人群。对于每例患者，我们通过要求匹配国家提供者标识符，并确保基于EHR的处方记录与初始降压药物处方门诊访视的药物、剂型和提供者国家提供者标识符上的药房填写记录匹配，将药房填写记录与基于EHR的门诊处方访视匹配。基线
Early effective antihypertensive initiation leads to better outcomes for newly diagnosed patients with hypertension. Current guidelines recommend initiation of combination therapy, with≥ 2 drugs, for patients with stage 2 hypertension (blood pressure [BP]≥ 140/90 mm Hg). 1 However, few real-world studies have assessed initial antihypertensive treatment in the context of baseline BP. 2 Consequently, we examined initial antihypertensive treatment patterns among Medicaid and Medicare recipients with linked claims and electronic health record (EHR) in the OneFlorida+ Research Consortium (hereafter, OneFlorida+).We conducted a cross-sectional study using a previously described cohort of Medicare-and Medicaid-insured adults (aged≥ 18 years) with hypertension who were new antihypertensive users from 2012 to 2021. 3 Medicaid recipients were adult Floridians primarily having low incomes, and Medicare recipients were adult Floridians aged≥ 65 years or with qualifying disability who had parts A, B, and D during the study period. From this cohort, we restricted the population to those with linked outpatient EHRs in OneFlorida+ from the putative prescribing visit. For each patient, we matched pharmacy fill records to the EHR-based outpatient prescribing visit by requiring matching National Provider Identifier and ensuring that EHR-based prescription records matched the pharmacy fill record on drug, dosage form, and provider National Provider Identifier for the outpatient visit where the initial antihypertensive medication was prescribed. Baseline