Medication Adherence and Clinical Outcome of Fixed-Dose Combination vs. Free Combination of Angiotensin Receptor Blocker and Statin
Background:Non-compliance with angiotensin receptor blockers (ARB) or statin is one of the major hurdles to optimal medical treatment. This study investigated whether fixed-dose combination (FDC) improved compliance to medication compared with traditional free combination (FC).Methods and Results:In...
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| Veröffentlicht in: | Circulation Journal 2021/04/23, Vol.85(5), pp.595-603 |
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| creator | Choi, Jung Min Lee, Seung-Hwa Jang, Yu Jeong Kang, Mira Choi, Jin-Ho |
| description | Background:Non-compliance with angiotensin receptor blockers (ARB) or statin is one of the major hurdles to optimal medical treatment. This study investigated whether fixed-dose combination (FDC) improved compliance to medication compared with traditional free combination (FC).Methods and Results:In this retrospective nationwide cohort study, medication persistency, medication adherence measured by proportion of days covered (PDC), and all-cause death of 123,992 patients who started ARB and stain were investigated for 540 days. Patients had a mean age of 63 years and 48% were male. Persistency, PDC, and proportion of PDC ≥80% of FDC (N=34,776) were higher than those for FC (N=89,216) in both unadjusted analysis (54.5% vs. 27.8%; 84.1% vs. 63.1%; 75.5% vs. 48.1%) and propensity-score matched analysis (P |
| doi_str_mv | 10.1253/circj.CJ-20-0966 |
| format | Article |
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This study investigated whether fixed-dose combination (FDC) improved compliance to medication compared with traditional free combination (FC).Methods and Results:In this retrospective nationwide cohort study, medication persistency, medication adherence measured by proportion of days covered (PDC), and all-cause death of 123,992 patients who started ARB and stain were investigated for 540 days. Patients had a mean age of 63 years and 48% were male. Persistency, PDC, and proportion of PDC ≥80% of FDC (N=34,776) were higher than those for FC (N=89,216) in both unadjusted analysis (54.5% vs. 27.8%; 84.1% vs. 63.1%; 75.5% vs. 48.1%) and propensity-score matched analysis (P<0.001, all). Death risk for the investigation period (0–540 days) was lower in FDC in unadjusted (1.8% vs. 2.6%, P<0.001) and adjusted cohort (P<0.05). In landmark analyses at days 180 and 360, there was no significant difference of death risk between FDC and FC (P>0.05).Conclusions:In this real-world data analysis, patients taking FDC of ARB and statin showed higher medication persistence and adherence compared to patients taking FC of ARB and statin up to 540 days. The risk of all-cause death was not different between FDC and FC despite better medication compliance in the FDC patients.</description><identifier>ISSN: 1346-9843</identifier><identifier>ISSN: 1347-4820</identifier><identifier>EISSN: 1347-4820</identifier><identifier>DOI: 10.1253/circj.CJ-20-0966</identifier><identifier>PMID: 33790135</identifier><language>eng</language><publisher>Japan: The Japanese Circulation Society</publisher><subject>Angiotensin Receptor Antagonists - therapeutic use ; Angiotensin receptor blocker ; Angiotensin-Converting Enzyme Inhibitors - therapeutic use ; Antihypertensive Agents - therapeutic use ; Clinical outcome ; Drug Therapy, Combination ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use ; Hypertension - drug therapy ; Male ; Medication Adherence ; Medication persistence ; Middle Aged ; Retrospective Studies ; Statin</subject><ispartof>Circulation Journal, 2021/04/23, Vol.85(5), pp.595-603</ispartof><rights>2021, THE JAPANESE CIRCULATION SOCIETY</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c669t-b04723e329f5db68bf7bda5f07a7c1a322e09f7bde2194fcbf722b0f0783fb9d3</citedby><cites>FETCH-LOGICAL-c669t-b04723e329f5db68bf7bda5f07a7c1a322e09f7bde2194fcbf722b0f0783fb9d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1877,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33790135$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Choi, Jung Min</creatorcontrib><creatorcontrib>Lee, Seung-Hwa</creatorcontrib><creatorcontrib>Jang, Yu Jeong</creatorcontrib><creatorcontrib>Kang, Mira</creatorcontrib><creatorcontrib>Choi, Jin-Ho</creatorcontrib><title>Medication Adherence and Clinical Outcome of Fixed-Dose Combination vs. Free Combination of Angiotensin Receptor Blocker and Statin</title><title>Circulation Journal</title><addtitle>Circ J</addtitle><description>Background:Non-compliance with angiotensin receptor blockers (ARB) or statin is one of the major hurdles to optimal medical treatment. This study investigated whether fixed-dose combination (FDC) improved compliance to medication compared with traditional free combination (FC).Methods and Results:In this retrospective nationwide cohort study, medication persistency, medication adherence measured by proportion of days covered (PDC), and all-cause death of 123,992 patients who started ARB and stain were investigated for 540 days. Patients had a mean age of 63 years and 48% were male. Persistency, PDC, and proportion of PDC ≥80% of FDC (N=34,776) were higher than those for FC (N=89,216) in both unadjusted analysis (54.5% vs. 27.8%; 84.1% vs. 63.1%; 75.5% vs. 48.1%) and propensity-score matched analysis (P<0.001, all). Death risk for the investigation period (0–540 days) was lower in FDC in unadjusted (1.8% vs. 2.6%, P<0.001) and adjusted cohort (P<0.05). In landmark analyses at days 180 and 360, there was no significant difference of death risk between FDC and FC (P>0.05).Conclusions:In this real-world data analysis, patients taking FDC of ARB and statin showed higher medication persistence and adherence compared to patients taking FC of ARB and statin up to 540 days. The risk of all-cause death was not different between FDC and FC despite better medication compliance in the FDC patients.</description><subject>Angiotensin Receptor Antagonists - therapeutic use</subject><subject>Angiotensin receptor blocker</subject><subject>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Clinical outcome</subject><subject>Drug Therapy, Combination</subject><subject>Humans</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use</subject><subject>Hypertension - drug therapy</subject><subject>Male</subject><subject>Medication Adherence</subject><subject>Medication persistence</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Statin</subject><issn>1346-9843</issn><issn>1347-4820</issn><issn>1347-4820</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkEtPGzEUha0KxCOw76ryks2kHnteXoahoUVBkaBdWx7PncTpjB1sp2rX_HGcR4PYXF_d851j6SD0OSXjlObsq9JOrcb1Q0JJQnhRfEIXKcvKJKsoOdntRcKrjJ2jS-9XhFBOcn6GzhkrOUlZfoFeH6HVSgZtDZ60S3BgFGBpWlz32kSlx_NNUHYAbDs81X-hTe6sB1zbodFmb_zjx3jq4OMx4hOz0DaA8drgJ1CwDtbh296q3-B2fzyHyJordNrJ3sP14R2hX9NvP-vvyWx-_6OezBJVFDwkDclKyoBR3uVtU1RNVzatzDtSylKlklEKhG9vQFOedSrqlDYk6hXrGt6yEbrZ566dfdmAD2LQXkHfSwN24wXNSVnSKroiSvaoctZ7B51YOz1I90-kRGyrF7vqRf0gKBHb6qPlyyF90wzQHg3_u47AdA-sfJALOALSBa16OCRWuci34z35HVhKJ8CwN-70m4c</recordid><startdate>20210423</startdate><enddate>20210423</enddate><creator>Choi, Jung Min</creator><creator>Lee, Seung-Hwa</creator><creator>Jang, Yu Jeong</creator><creator>Kang, Mira</creator><creator>Choi, Jin-Ho</creator><general>The Japanese Circulation Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20210423</creationdate><title>Medication Adherence and Clinical Outcome of Fixed-Dose Combination vs. Free Combination of Angiotensin Receptor Blocker and Statin</title><author>Choi, Jung Min ; Lee, Seung-Hwa ; Jang, Yu Jeong ; Kang, Mira ; Choi, Jin-Ho</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c669t-b04723e329f5db68bf7bda5f07a7c1a322e09f7bde2194fcbf722b0f0783fb9d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Angiotensin Receptor Antagonists - therapeutic use</topic><topic>Angiotensin receptor blocker</topic><topic>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Clinical outcome</topic><topic>Drug Therapy, Combination</topic><topic>Humans</topic><topic>Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use</topic><topic>Hypertension - drug therapy</topic><topic>Male</topic><topic>Medication Adherence</topic><topic>Medication persistence</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Statin</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Choi, Jung Min</creatorcontrib><creatorcontrib>Lee, Seung-Hwa</creatorcontrib><creatorcontrib>Jang, Yu Jeong</creatorcontrib><creatorcontrib>Kang, Mira</creatorcontrib><creatorcontrib>Choi, Jin-Ho</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Choi, Jung Min</au><au>Lee, Seung-Hwa</au><au>Jang, Yu Jeong</au><au>Kang, Mira</au><au>Choi, Jin-Ho</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Medication Adherence and Clinical Outcome of Fixed-Dose Combination vs. Free Combination of Angiotensin Receptor Blocker and Statin</atitle><jtitle>Circulation Journal</jtitle><addtitle>Circ J</addtitle><date>2021-04-23</date><risdate>2021</risdate><volume>85</volume><issue>5</issue><spage>595</spage><epage>603</epage><pages>595-603</pages><issn>1346-9843</issn><issn>1347-4820</issn><eissn>1347-4820</eissn><abstract>Background:Non-compliance with angiotensin receptor blockers (ARB) or statin is one of the major hurdles to optimal medical treatment. This study investigated whether fixed-dose combination (FDC) improved compliance to medication compared with traditional free combination (FC).Methods and Results:In this retrospective nationwide cohort study, medication persistency, medication adherence measured by proportion of days covered (PDC), and all-cause death of 123,992 patients who started ARB and stain were investigated for 540 days. Patients had a mean age of 63 years and 48% were male. Persistency, PDC, and proportion of PDC ≥80% of FDC (N=34,776) were higher than those for FC (N=89,216) in both unadjusted analysis (54.5% vs. 27.8%; 84.1% vs. 63.1%; 75.5% vs. 48.1%) and propensity-score matched analysis (P<0.001, all). Death risk for the investigation period (0–540 days) was lower in FDC in unadjusted (1.8% vs. 2.6%, P<0.001) and adjusted cohort (P<0.05). In landmark analyses at days 180 and 360, there was no significant difference of death risk between FDC and FC (P>0.05).Conclusions:In this real-world data analysis, patients taking FDC of ARB and statin showed higher medication persistence and adherence compared to patients taking FC of ARB and statin up to 540 days. The risk of all-cause death was not different between FDC and FC despite better medication compliance in the FDC patients.</abstract><cop>Japan</cop><pub>The Japanese Circulation Society</pub><pmid>33790135</pmid><doi>10.1253/circj.CJ-20-0966</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Angiotensin Receptor Antagonists - therapeutic use Angiotensin receptor blocker Angiotensin-Converting Enzyme Inhibitors - therapeutic use Antihypertensive Agents - therapeutic use Clinical outcome Drug Therapy, Combination Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use Hypertension - drug therapy Male Medication Adherence Medication persistence Middle Aged Retrospective Studies Statin |
| title | Medication Adherence and Clinical Outcome of Fixed-Dose Combination vs. Free Combination of Angiotensin Receptor Blocker and Statin |
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