Antihypertensive Medication Nonadherence and Hypertension Prevalence with Team Up. Pressure Down. Pharmacy Locations, by County

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Key points

This map, in conjunction with an Excel spreadsheet, was used to identify community pharmacies in counties with high blood pressure nonadherence rates and/or high hypertension prevalence.

Map

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This map illustrates the antihypertensive medication nonadherence and hypertension prevalence among Medicare Part D beneficiaries 65 years and older at the county level for 2014. The highest rates of blood pressure medication nonadherence was less than 31 percent are noted in two counties with a large area covered by three of Montana’s American Indian reservations. Counties with the lowest blood pressure medication nonadherence rates--40 percent--hypertension prevalence rates are scattered throughout the state, with clusters in the eastern part of the state. Also illustrated are the locations of the community pharmacies that participated in the Team Up. Pressure Down. (TUPD) project. A large majority of TUPD community pharmacy subawardees are located in the western part of Montana, but only a few community pharmacies in the eastern part of the state are participating in the TUPD project.
Antihypertensive Medication Nonadherence and Hypertension Prevalence with Team Up. Pressure Down. Pharmacy Locations, by County

Data sources

Major Findings

Poor blood pressure medication adherence can lead to poor control of high blood pressure and increases the likelihood of hospitalization and premature death. Counties in the Central Valley tend to have higher blood pressure medication nonadherence than other counties in California do. This map is a call to action to Central Valley health systems to address poor blood pressure control through improved care to reduce hospitalizations and premature mortality.

How the map will be used, or has been used

This map is the first of two maps that were shared with the Montana Cardiovascular Health Program's consulting pharmacist and the former Montana Pharmacy Association president to assist in recruiting community pharmacies to participate in the 5th year of the TUPD project. Also, after presenting this map and other medication adherence maps to the Montana Primary Care Association, potential projects were discussed for community health centers with an on-site pharmacy.

ArcGIS

Data Sources: Blood Pressure Medication Usage Among Hypertensive Patients, California Health Interview Survey, 2013–2014; Premature Hypertension-Related Mortality, California Death Statistical Master File, 2012–2014; Preventable Hypertension-Related Hospitalization, Patient Discharge Data, California Office of Statewide Health Planning and Development, 2012–2014; Medi-Cal Blood Pressure Medication Adherence, 2014; Medicare Blood Pressure Medication Adherence, CDC Interactive Atlas of Heart Disease and Stroke, 2014.

County ranks are presented on a common scale for all five maps. A choropleth-style map with nine classes was used to symbolize the spatial variation represented in each map. The first map (A) shows blood pressure medication usage among hypertensive patients (2013 to 2014) from the California Health Interview Survey. San Joaquin and Merced counties are ranked very high (having very poor hypertension medication usage). Fresno and Stanislaus are slightly below them, and Kings, Tulare, Kern, and Madera counties are ranked much lower (having better medication usage). The second map (B) displays the rate of premature hypertension-related mortality for the years 2012 through 2014. San Joaquin, Merced, and Kern counties are all within the top five California counties (having the highest mortality rates). The third map (C) displays preventable hypertension-related hospitalization for the years 2012 through 2014. All of these counties except for Madera are in the top 15 for worst hospitalization rate in California. The fourth map (D) displays blood pressure medication nonadherence among the Medicaid population. All of the counties except for Kern and Madera counties are in the top 15 for worst medication adherence in California. The final map (E) displays blood pressure medication adherence among the Medicare population. Merced, Kings, Tulare, and Kern counties are all in the top 10 for worst medication adherence in California.

Brendan Darsie, Research Scientist II, California Department of Public Health
916-324-0090
brendan.darsie@cdph.ca.gov

Brendan Darsie, California Department of Public Health. Accessed from the Centers for Disease Control and Prevention's Chronic Disease Map Gallery.

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Content Source:
National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP); About the Division for Heart Disease and Stroke Prevention