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The effect of adherence on antihypertensive therapy plans in patients with diabetes

Abstract Patient adherence to a medication plan may significantly impact the benefits received by therapy. Thus, considering patient adherence to antihypertensive medication therapy in patients with diabetes, we investigate the impacts of adherence levels on patient health outcomes using a finite horizon, discounted Markov decision process. Health states are based on varying systolic blood pressure levels, cardiovascular complications, adherence levels, and the patient’s current hypertension medications. We model patient transitions through these health states by combining various models from the literature. The model maximizes the expected quality-adjusted life years (QALY). Experimentation on varying levels of patient adherence to medication plans emphasizes the importance of adherence to medication plans with respect to a quality of life metric. Furthermore, sensitivity analysis of model factors finds that smoking as an internal factor, and model parameters as external factors highly influence health outcomes. Furthermore, when patients maintain a higher than average adherence level, they will be able to noticeably increase their expected QALYs.