title: Pill burden in hypertensive patients treated with single-pill combination therapy--an observational study.
abstract: BACKGROUND
  Hypertension is a condition which in many cases is treated with more than one drug. Additionally, patients with hypertension often suffer from other concomitant diseases, such as diabetes mellitus or dyslipidemia, which adds to the number of pills that patients need to take (pill burden). The aim of this study was to investigate the impact of this pill burden on patients with hypertension in clinical practice in Germany.
  
  
  METHODS
  This prospective, open-label, observational study enrolled adult patients for whom their physician considered treatment with a single-pill combination of amlodipine, valsartan, and hydrochlorothiazide as indicated. At the start of the observation period, physicians and patients filled in a respective questionnaire.
  
  
  RESULTS
  The questionnaires of 7,101 patients and 905 physicians were analyzed. The survey among the patients showed that the majority of patients felt burdened by the high number of pills to be taken. This was also seen as a potential reason for medication errors. Approximately half of the patients would be willing to make an out-of-pocket payment for reducing the number of pills to half. The results of the physician questionnaire indicate that the physicians were well aware of the set of problems that is generally associated with the high pill burden and that there is a clear willingness to use combination products in order to reduce the pill burden.
  
  
  CONCLUSIONS
  A high number of pills is considered a burden by the patients. This burden increases with the number of pills taken per day.
authors.affiliation: Department of Cardiology-Angiology, University Hospital Leipzig, 04103, Leipzig, Germany. andreas.hagendorff@medizin.uni-leipzig.de
authors.forename: Andreas
authors.initials: A
authors.lastname: Hagendorff
authors.forename: Siegfried
authors.initials: S
authors.lastname: Freytag
authors.forename: Alfons
authors.initials: A
authors.lastname: Müller
authors.forename: Sven
authors.initials: S
authors.lastname: Klebs
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017311:Amlodipine / Q000008:administration & dosage*; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D017281:Cost of Illness; D004338:Drug Combinations; D004359:Drug Therapy, Combination / Q000523:psychology; D005260:Female; D005858:Germany; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage*; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013777:Tetrazoles / Q000008:administration & dosage*; D014633:Valine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000068756:Valsartan
chemical_list: D000959:Antihypertensive Agents; D004338:Drug Combinations; D013777:Tetrazoles; D006852:Hydrochlorothiazide; D017311:Amlodipine; D000068756:Valsartan; D014633:Valine