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.
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.
Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.
C-I
CI
Hsu
Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.|School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.|Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan.
F-Y
FY
Hsiao
Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.|School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.|Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan.
F-L L
FL
Wu
Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.|School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.|Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan.
L-J
LJ
Shen
D000328:Adult; D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000008:administration & dosage*; D000959:Antihypertensive Agents / Q000008:administration & dosage; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D004363:Drug Utilization / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D015994:Incidence; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D012189:Retrospective Studies; D049993:Sodium Chloride Symporter Inhibitors / Q000008:administration & dosage*; D015996:Survival Rate / Q000639:trends; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D057911:Angiotensin Receptor Antagonists; D000959:Antihypertensive Agents; D049993:Sodium Chloride Symporter Inhibitors