https://scholars.lib.ntu.edu.tw/handle/123456789/466103
標題: | Bidirectional adherence changes and associated factors in patients switched from free combinations to equivalent single-pill combinations of antihypertensive drugs | 作者: | TZUNG-DAU WANG YING-HSIEN CHEN CHIEN-HUA HUANG WEN-JONE CHEN MING-FONG CHEN |
公開日期: | 2014 | 卷: | 63 | 期: | 5 | 起(迄)頁: | 958-967 | 來源出版物: | Hypertension | 摘要: | There are no reported studies assessing the effects of fixed-dose single-pill combinations (SPCs) of antihypertensive drugs on adherence in real-world patients with hypertension switched from free combinations to the corresponding SPCs. In this retrospective cohort study with a 1-year mirror-image design, a total of 896 patients who had been prescribed with an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker and a thiazide-type diuretic within the preceding 12 months of the index (switching) date and the corresponding SPC within 12 months after the index date were included by using the Taiwan National Health Insurance database from January 2001 to December 2007. Adherence was measured by medication possession ratio (MPR). For patients switched to SPCs, the MPR increased significantly from 42% in the preindex period to 69% in the postindex period (relative difference, 75%; 95% confidence interval, 58%-100%; P<0.001). However, for switched patients with high adherence (MPR ?0.8) in the preindex period, the MPR unexpectedly decreased in the postindex period (absolute difference, -13%; 95% confidence interval, -17% to -9%; P<0.001). In multivariate analysis, MPR difference was inversely related to the preindex MPR, the number of other antihypertensive drugs, and congestive heart failure. In summary, despite of the dramatic effect of SPCs on improving adherence, this strategy is not effective or even worse in patients adequately adhering to their free-combined antihypertensive regimens. The inverse association between adherence improvement and number of concurrent antihypertensive drugs suggests early use of SPCs to curtail the nonadherence gap. ? 2014 American Heart Association, Inc. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/466103 | ISSN: | 0194-911X | DOI: | 10.1161/HYPERTENSIONAHA.113.02455 | SDG/關鍵字: | angiotensin receptor antagonist; antihypertensive agent; dipeptidyl carboxypeptidase; dipeptidyl carboxypeptidase inhibitor; thiazide diuretic agent; adult; aged; antihypertensive therapy; article; cohort analysis; confidence interval; congestive heart failure; controlled study; data base; drug formulation; drug substitution; female; human; hypertension; major clinical study; male; medication compliance; middle aged; multivariate analysis; national health insurance; patient compliance; priority journal; single pill combination; antihypertensive agents; drug combinations; hypertension; medication adherence; polypharmacy; population; Age Factors; Aged; Aged, 80 and over; Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Antihypertensive Agents; Cohort Studies; Databases, Factual; Drug Combinations; Drug Therapy, Combination; Female; Humans; Hypertension; Linear Models; Male; Middle Aged; Patient Compliance; Retrospective Studies; Sex Factors; Sodium Chloride Symporter Inhibitors; Taiwan |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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