101
Views
8
CrossRef citations to date
0
Altmetric
Original article

Construction and validation of a model to predict nonadherence to guidelines for prescribing antiplatelet therapy to hypertensive patients

, , , , , , & show all
Pages 883-889 | Accepted 11 Mar 2015, Published online: 07 Apr 2015
 

Abstract

Objective:

To construct and validate a model to predict nonadherence to guidelines for prescribing antiplatelet therapy (NGAT) to hypertensive patients.

Methods:

This 3 month prospective study was undertaken in 2007–2009 to determine whether 712 hypertensive patients were or were not being prescribed antiplatelet therapy. Outcome: NGAT according to clinical guidelines (just for patients in secondary prevention or with Systematic COronary Risk Evaluation (SCORE) ≥10%). Secondary variables: Duration of hypertension (years), blood pressure (BP), age, gender, smoking, diabetes, dyslipidemia, cardiovascular disease, lipid parameters, SCORE. Of the whole sample 80% was used to construct the model and 20% to validate it. To construct the model, we performed a multivariate logistic regression model which was adapted to be a scoring system with risk groups. The adjusted odds ratios (ORs) were obtained through the model. To validate the model we calculated the area under the ROC curve (AUC) and then compared the expected and the observed NGAT. The final model was adapted for use as a mobile application.

Results:

NGAT: 18.5%, construction; 17.9%, validation. Factors: higher duration of hypertension diagnosis, higher systolic BP, older age, male gender, smoking, diabetes, dyslipidemia and cardiovascular disease. Validation: AUC = 0.82 (95% CI: 0.74–0.90, p < 0.001), with no differences between the observed and the expected NGAT (p = 0.334).

Conclusion:

A tool was constructed and validated to predict NGAT. The associated factors were related with a greater cardiovascular risk. The scoring system has to be validated in other areas.

Transparency

Declaration of funding

A research grant from the Department of Clinical Medicine at Miguel Hernández University was used to buy reagents for biochemical testing. This entity had no role in data collection, analysis, or interpretation; nor did it have the right to approve or disapprove publication of the finished manuscript.

Declaration of financial/other relationships

A.P.-B., M.J.M.-O., Z.P.-T., A.S., D.M.F.-d.l.R., D.O.-B., C.C.-M., and V.F.G.-G. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

We thank the Conselleria de Sanitat (Comunidad Valenciana) for allowing us to use the health center teams and the health system computerized records. The authors also thank Ian Johnstone for help with the English language version of the text.

Log in via your institution

Log in to Taylor & Francis Online

PDF download + Online access

  • 48 hours access to article PDF & online version
  • Article PDF can be downloaded
  • Article PDF can be printed
USD 65.00 Add to cart

Issue Purchase

  • 30 days online access to complete issue
  • Article PDFs can be downloaded
  • Article PDFs can be printed
USD 681.00 Add to cart

* Local tax will be added as applicable

Related Research

People also read lists articles that other readers of this article have read.

Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine.

Cited by lists all citing articles based on Crossref citations.
Articles with the Crossref icon will open in a new tab.