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Patterns in blood pressure medication use in US incident dialysis patients over the first 6 months.

Publication ,  Journal Article
St Peter, WL; Sozio, SM; Shafi, T; Ephraim, PL; Luly, J; McDermott, A; Bandeen-Roche, K; Meyer, KB; Crews, DC; Scialla, JJ; Miskulin, DC ...
Published in: BMC Nephrol
November 12, 2013

BACKGROUND: Several observational studies have evaluated the effect of a single exposure window with blood pressure (BP) medications on outcomes in incident dialysis patients, but whether BP medication prescription patterns remain stable or a single exposure window design is adequate to evaluate effect on outcomes is unclear. METHODS: We described patterns of BP medication prescription over 6 months after dialysis initiation in hemodialysis and peritoneal dialysis patients, stratified by cardiovascular comorbidity, diabetes, and other patient characteristics. The cohort included 13,072 adult patients (12,159 hemodialysis, 913 peritoneal dialysis) who initiated dialysis in Dialysis Clinic, Inc., facilities January 1, 2003-June 30, 2008, and remained on the original modality for at least 6 months. We evaluated monthly patterns in BP medication prescription over 6 months and at 12 and 24 months after initiation. RESULTS: Prescription patterns varied by dialysis modality over the first 6 months; substantial proportions of patients with prescriptions for beta-blockers, renin angiotensin system agents, and dihydropyridine calcium channel blockers in month 6 no longer had prescriptions for these medications by month 24. Prescription of specific medication classes varied by comorbidity, race/ethnicity, and age, but little by sex. The mean number of medications was 2.5 at month 6 in hemodialysis and peritoneal dialysis cohorts. CONCLUSIONS: This study evaluates BP medication patterns in both hemodialysis and peritoneal dialysis patients over the first 6 months of dialysis. Our findings highlight the challenges of assessing comparative effectiveness of a single BP medication class in dialysis patients. Longitudinal designs should be used to account for changes in BP medication management over time, and designs that incorporate common combinations should be considered.

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Published In

BMC Nephrol

DOI

EISSN

1471-2369

Publication Date

November 12, 2013

Volume

14

Start / End Page

249

Location

England

Related Subject Headings

  • Urology & Nephrology
  • United States
  • Treatment Outcome
  • Survival Rate
  • Risk Factors
  • Renal Insufficiency, Chronic
  • Renal Dialysis
  • Prevalence
  • Prescriptions
  • Practice Patterns, Physicians'
 

Citation

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St Peter, W. L., Sozio, S. M., Shafi, T., Ephraim, P. L., Luly, J., McDermott, A., … DEcIDE Network Patient Outcomes in End-Stage Renal Disease Study Investigators, . (2013). Patterns in blood pressure medication use in US incident dialysis patients over the first 6 months. BMC Nephrol, 14, 249. https://doi.org/10.1186/1471-2369-14-249
St Peter, Wendy L., Stephen M. Sozio, Tariq Shafi, Patti L. Ephraim, Jason Luly, Aidan McDermott, Karen Bandeen-Roche, et al. “Patterns in blood pressure medication use in US incident dialysis patients over the first 6 months.BMC Nephrol 14 (November 12, 2013): 249. https://doi.org/10.1186/1471-2369-14-249.
St Peter WL, Sozio SM, Shafi T, Ephraim PL, Luly J, McDermott A, et al. Patterns in blood pressure medication use in US incident dialysis patients over the first 6 months. BMC Nephrol. 2013 Nov 12;14:249.
St Peter, Wendy L., et al. “Patterns in blood pressure medication use in US incident dialysis patients over the first 6 months.BMC Nephrol, vol. 14, Nov. 2013, p. 249. Pubmed, doi:10.1186/1471-2369-14-249.
St Peter WL, Sozio SM, Shafi T, Ephraim PL, Luly J, McDermott A, Bandeen-Roche K, Meyer KB, Crews DC, Scialla JJ, Miskulin DC, Tangri N, Jaar BG, Michels WM, Wu AW, Boulware LE, DEcIDE Network Patient Outcomes in End-Stage Renal Disease Study Investigators. Patterns in blood pressure medication use in US incident dialysis patients over the first 6 months. BMC Nephrol. 2013 Nov 12;14:249.
Journal cover image

Published In

BMC Nephrol

DOI

EISSN

1471-2369

Publication Date

November 12, 2013

Volume

14

Start / End Page

249

Location

England

Related Subject Headings

  • Urology & Nephrology
  • United States
  • Treatment Outcome
  • Survival Rate
  • Risk Factors
  • Renal Insufficiency, Chronic
  • Renal Dialysis
  • Prevalence
  • Prescriptions
  • Practice Patterns, Physicians'