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Adherence and medication utilisation patterns of fixed-dose and free combination of angiotensin receptor blocker/thiazide diuretics among newly diagnosed hypertensive patients: a population-based cohort study

Int J Clin Pract. 2015 Jul;69(7):729-37. doi: 10.1111/ijcp.12591. Epub 2014 Nov 14.

Abstract

Objective: The study aimed to compare the adherence and persistence among newly diagnosed hypertensive patients using fixed-dose (FDC) and free combinations (FC) of angiotensin receptor blocker (ARB)/thiazide diuretic using Taiwan's National Health Insurance Research Database.

Methods: General linear regression and Kaplan-Meier analyses were used to estimate the impact of FDC on adherence [measured by medication possession ratio (MPR)] and persistence (time from day of initiation to treatment discontinuation) of ARB/thiazide diuretic.

Results: The adjusted MPRs were all significantly higher among FDC group compared with FC group (6 months: 66.55% vs. 63.86%; 1 year: 52.58% vs. 46.73%, 1.5 year: 46.30% vs. 38.07%; 2 year: 42.06% vs. 32.45%, all p < 0.001). Patients received FDC therapy were less likely to discontinue their therapy [adjusted hazard ratio (HR) 0.79, 95% CI = 0.74-0.85].

Conclusions: Our findings suggest that use of FDC is associated with higher adherence and persistence rates than use of FC in newly diagnosed hypertensive patients.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Angiotensin Receptor Antagonists / administration & dosage*
  • Antihypertensive Agents / administration & dosage
  • Blood Pressure / drug effects
  • Blood Pressure / physiology*
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Drug Utilization / trends*
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / epidemiology
  • Hypertension / physiopathology
  • Incidence
  • Male
  • Medication Adherence*
  • Middle Aged
  • Retrospective Studies
  • Sodium Chloride Symporter Inhibitors / administration & dosage*
  • Survival Rate / trends
  • Taiwan / epidemiology
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Angiotensin Receptor Antagonists
  • Antihypertensive Agents
  • Sodium Chloride Symporter Inhibitors