TARGET ORGAN DAMAGE AND THE LONG TERM EFFECT OF NONADHERENCE TO CLINICAL PRACTICE GUIDELINES IN PATIENTS WITH HYPERTENSION- A RETROSPECTIVE COHORT STUDY.

Author(s)

Abegaz TM¹, Tefera YG², Abebe TB¹
¹University of Gondar, Gondar, Ethiopia, ²University of Gondar, City, Ethiopia

OBJECTIVES: There was limited published data on target organ damage (TOD) and the eﬀect of nonadherence to practice guidelines in Ethiopia. This study determined TOD and the long term eﬀect of nonadherence to clinical guidelines on hypertensive patients.

METHODS: An open level retrospective cohort study has been employed at cardiac clinic of Gondar university hospital for a mean follow-up period of 78 months. Multivariate Cox regression was conducted to test associating factors of TOD. Kaplan analysis was done to evaluate the long term effect of nonadherence to practice guidelines on TOD. A person-time method was applied to calculate the incidence rate of TODs

RESULTS: Of the total number of 612 patients examined, the overall prevalence of hypertensive TOD was 40.3%. The presence of comorbidities, COR = 1.073 [1.01–1.437], AOR = 1.196 [1.174–1.637], and nonadherence to clinical practice guidelines, COR = 1.537 [1.167–2.024], AOR = 1.636 [1.189–2.251], were found to be predicting factors for TOD. According to Kaplan-Meier analysis patients who were initiated on appropriate medication tended to develop TOD very late: Log Rank [11.975 ( p=0.01)]

CONCLUSIONS: More than forty percent of patients acquired TOD which is more signifcant. Presence of comorbidities and nonadherence to practice guidelines were correlated with the incidence of TOD. Appropriate management of hypertension and modifcation of triggering factors are essential to prevent complications.

Conference/Value in Health Info

2017-11, ISPOR Europe 2017, Glasgow, Scotland

Value in Health, Vol. 20, No. 9 (October 2017)

Code

PCV23

Topic

Clinical Outcomes, Epidemiology & Public Health

Topic Subcategory

Comparative Effectiveness or Efficacy, Relating Intermediate to Long-term Outcomes

Disease

Cardiovascular Disorders

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