Achieving Adherence After First-Line Antihypertensive Treatment: Should Fixed-Dose Combinations Receive Priority?

Autor:	Sonawane Deshmukh KB; Department of Health Outcomes Research and Policy, Auburn University, Auburn, AL., Qian J; Department of Health Outcomes Research and Policy, Auburn University, Auburn, AL., Garza KB; Department of Health Outcomes Research and Policy, Auburn University, Auburn, AL., Wright BM; Pharmacy Practice, Auburn University, Auburn, AL.; The University of Alabama at Birmingham, Huntsville, AL., Zeng P; Mathematics and Statistics, Auburn University, Auburn, AL., Ganduglia Cazaban CM; Management Policy and Community Health, The University of Texas Health Science Centre at Houston, Houston, TX., Hansen RA; Department of Health Outcomes Research and Policy, Auburn University, Auburn, AL. rah0019@auburn.edu.
Jazyk:	angličtina
Zdroj:	Journal of clinical hypertension (Greenwich, Conn.) [J Clin Hypertens (Greenwich)] 2016 Sep; Vol. 18 (9), pp. 934-41. Date of Electronic Publication: 2016 Feb 24.
DOI:	10.1111/jch.12799
Abstrakt:	Data on the long-term outcomes of the use of fixed-dose combinations (FDCs) or free-pill combinations (FPCs), titration of doses, and switching are currently unavailable for identifying a preferred strategy for adherence. In the lack of these evidences, adherence can be a useful guiding criteria. The authors conducted a retrospective cohort study using the BlueCross BlueShield of Texas (2008-2012) database to compare adherence among 5998 patients who received treatment modifications (TMs). Results of the propensity score-adjusted model indicate that FDC and uptitration strategies have higher odds of adherence compared with the switch strategy (P<.05). Among patients with a history of poor adherence, the odds of adherence were up to 26% higher for the FDC strategy compared with alternative strategies (P<.05). Factors including age, number of comedications, first-line drug class, and health services utilization are associated with adherence. In conclusion, FDCs should be prioritized for TM, particularly if the patient has a history of poor adherence. (© 2016 Wiley Periodicals, Inc.)
Databáze:	MEDLINE
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