title: Does a combination pill of antihypertensive drugs improve medication adherence in Japanese? A randomized controlled trial.
abstract: BACKGROUND
  In order to achieve target blood pressure levels to prevent cardiovascular disease, combination therapy of antihypertensive drugs is often required, although it is thought that requiring a patient to take many different pills would reduce adherence to the medication regimen. Whether antihypertensive treatment with a single pill combining antihypertensive drugs would improve medication adherence and blood pressure control was investigated.
  
  
  RESULTS
  A total of 207 hypertensive subjects were randomly assigned to a combination pill group (losartan 50mg/hydrochlorothiazide 12.5mg; n=103) or a control group (an angiotensin receptor blocker and a thiazide diuretic; n=104). Medication adherence was evaluated by pill counts at 1, 3, and 6 months after randomization. The mean adherence rates over 6 months were not different between the 2 groups: 98% in the combination pill group and 98% in the control group. Moreover, the 2 groups included similar numbers of subjects with relatively poor adherence rates (<90%) in each treatment period. The mean blood pressures over the 6-month treatment period were not different between the groups: 131/75 mmHg in the combination pill group and 130/75 mmHg in the control group (P=0.84/0.96).
  
  
  CONCLUSIONS
  There were no appreciable effects of the combination pill of antihypertensive drugs on medication adherence or blood pressure control in Japanese patients over a 6-month period.
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. matsumk@intmed2.med.kyushu-u.ac.jp
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Matsumura
authors.forename: Hisatomi
authors.initials: H
authors.lastname: Arima
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Tominaga
authors.forename: Toshio
authors.initials: T
authors.lastname: Ohtsubo
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Sasaguri
authors.forename: Koji
authors.initials: K
authors.lastname: Fujii
authors.forename: Masayo
authors.initials: M
authors.lastname: Fukuhara
authors.forename: Keiko
authors.initials: K
authors.lastname: Uezono
authors.forename: Yuki
authors.initials: Y
authors.lastname: Morinaga
authors.forename: Yuko
authors.initials: Y
authors.lastname: Ohta
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Otonari
authors.forename: Junya
authors.initials: J
authors.lastname: Kawasaki
authors.forename: Isao
authors.initials: I
authors.lastname: Kato
authors.forename: Takuya
authors.initials: T
authors.lastname: Tsuchihashi
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000704:Analysis of Variance; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D044466:Asian People / Q000523:psychology*; D001794:Blood Pressure / Q000187:drug effects*; D016009:Chi-Square Distribution; D004232:Diuretics / Q000008:administration & dosage / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage / Q000627:therapeutic use*; D006973:Hypertension / Q000188:drug therapy* / Q000208:ethnology / Q000503:physiopathology; D007564:Japan / Q000453:epidemiology; D016014:Linear Models; D019808:Losartan / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D055118:Medication Adherence / Q000208:ethnology*; D008875:Middle Aged; D013607:Tablets; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D004232:Diuretics; D004338:Drug Combinations; D013607:Tablets; C505809:hydrochlorothiazide, losartan drug combination; D006852:Hydrochlorothiazide; D019808:Losartan