Results of a pilot pharmacotherapy quality improvement program using fixed-dose, combination amlodipine/benazepril antihypertensive therapy in a long-term care setting
Background: Hypertension is common in older adults (aged ≥65 years). Treatment frequently requires multiple medications and can be expensive. Objective: This study measured the impact of substituting low-dose, fixed-combination therapy using the calcium channel blocker (CCB) amlodipine and the angio...
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| Veröffentlicht in: | Clinical therapeutics 2003-06, Vol.25 (6), p.1872-1887 |
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| creator | Sapienza, Salvatore Sacco, Patricia Floyd, Kristine DiCesare, Joseph Doan, QuynhChau Diem |
| description | Background: Hypertension is common in older adults (aged ≥65 years). Treatment frequently requires multiple medications and can be expensive.
Objective: This study measured the impact of substituting low-dose, fixed-combination therapy using the calcium channel blocker (CCB) amlodipine and the angiotensin-converting enzyme (ACE) inhibitor benazepril for high-dose CCB monotherapy or dual therapy with a CCB and an ACE inhibitor on antihypertensive drug costs, the incidence of adverse events, and blood-pressure control.
Methods: A multicenter, pilot pharmacotherapy quality improvement program was undertaken in a long-term care facility setting. Consultant pharmacists reviewed pharmacy records and medical charts from long-term care facilities, identifying older patients with a diagnosis of hypertension who either took CCB concomitantly with an ACE inhibitor or experienced adverse events on high-dose CCB therapy. Eligible patients were identified and their physicians contacted regarding switching them to fixed-dose combination therapy.
Results: A total of 51 patients at 17 facilities were switched to fixed-dose amlodipine/benazepril combination therapy; 94.1% were women and 5.9% were men (mean age, 85.1 years; range, 64–99 years). The mean number of comorbidities was 1.6. During the subsequent 2 months, mean blood pressure remained at levels similar to those at baseline. The number of patients reporting at least 1 drug-related adverse event decreased by 81.8% (
P < 0.05), and the incidence of edema decreased by 75.0%. The mean per-patient cost of antihypertensive drugs decreased by 33.1% (
P < 0.001), a mean per-patient savings of $19.21 per month.
Conclusion: In patients aged ≥65 years with hypertension in long-term care facilities, a change from high-dose CCB monotherapy or CCB/ACE-inhibitor dual therapy to fixed-dose combination amlodipine/benazepril therapy significantly reduced drug costs and the incidence of adverse events and maintained blood-pressure control. |
| doi_str_mv | 10.1016/S0149-2918(03)80174-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_73490757</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0149291803801741</els_id><sourcerecordid>2731960221</sourcerecordid><originalsourceid>FETCH-LOGICAL-c419t-b08c760dfff2b1564d6c7e280afcedff2d3cb74ef7dfcd9c1359e21c8b2f5f4c3</originalsourceid><addsrcrecordid>eNqF0d1qFDEUB_Agit1WH0EJSIuCY5NMZiZzJVL8goLgB3gXMsnJbspMMk0yi-sL-Zqm3dWCN14Fwu-ck5w_Qk8oeUUJbc-_EMr7ivVUPCf1C0Foxyt6D62o6PqKUv79Plr9JUfoOKUrQkjdN-whOqJMtKQh9Qr9-gxpGXPCwWKFZzeGjOeNipPSIW8gqnmHrxc1urzDbppj2MIEvpgY1lFNeEnOr7F1P8BUJiR4iXWYBudVdsFjNY3BuNl5OB_Aq58wRzdi5bPb7GaIGXxyW8B_BrlSgcfg11WGOGGtIuAEOZcRj9ADq8YEjw_nCfr27u3Xiw_V5af3Hy_eXFaa0z5XAxG6a4mx1rKBNi03re6ACaKshnLLTK2HjoPtjNWm17RuemBUi4HZxnJdn6Czfd_ywesFUpaTSxrGUXkIS5JdzXvSNV2Bz_6BV2GJvrxNUlKzTlDG2qKavdIxpBTByrKBScVdQfImR3mbo7wJSZJa3uYoaal7eui-DBOYu6pDcAWcHoBKWo02Kq9dunO850QIUdzrvYOytK2DKJN24MsyXASdpQnuP0_5DVufwA4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1032781226</pqid></control><display><type>article</type><title>Results of a pilot pharmacotherapy quality improvement program using fixed-dose, combination amlodipine/benazepril antihypertensive therapy in a long-term care setting</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><source>ProQuest Central UK/Ireland</source><creator>Sapienza, Salvatore ; Sacco, Patricia ; Floyd, Kristine ; DiCesare, Joseph ; Doan, QuynhChau Diem</creator><creatorcontrib>Sapienza, Salvatore ; Sacco, Patricia ; Floyd, Kristine ; DiCesare, Joseph ; Doan, QuynhChau Diem</creatorcontrib><description>Background: Hypertension is common in older adults (aged ≥65 years). Treatment frequently requires multiple medications and can be expensive.
Objective: This study measured the impact of substituting low-dose, fixed-combination therapy using the calcium channel blocker (CCB) amlodipine and the angiotensin-converting enzyme (ACE) inhibitor benazepril for high-dose CCB monotherapy or dual therapy with a CCB and an ACE inhibitor on antihypertensive drug costs, the incidence of adverse events, and blood-pressure control.
Methods: A multicenter, pilot pharmacotherapy quality improvement program was undertaken in a long-term care facility setting. Consultant pharmacists reviewed pharmacy records and medical charts from long-term care facilities, identifying older patients with a diagnosis of hypertension who either took CCB concomitantly with an ACE inhibitor or experienced adverse events on high-dose CCB therapy. Eligible patients were identified and their physicians contacted regarding switching them to fixed-dose combination therapy.
Results: A total of 51 patients at 17 facilities were switched to fixed-dose amlodipine/benazepril combination therapy; 94.1% were women and 5.9% were men (mean age, 85.1 years; range, 64–99 years). The mean number of comorbidities was 1.6. During the subsequent 2 months, mean blood pressure remained at levels similar to those at baseline. The number of patients reporting at least 1 drug-related adverse event decreased by 81.8% (
P < 0.05), and the incidence of edema decreased by 75.0%. The mean per-patient cost of antihypertensive drugs decreased by 33.1% (
P < 0.001), a mean per-patient savings of $19.21 per month.
Conclusion: In patients aged ≥65 years with hypertension in long-term care facilities, a change from high-dose CCB monotherapy or CCB/ACE-inhibitor dual therapy to fixed-dose combination amlodipine/benazepril therapy significantly reduced drug costs and the incidence of adverse events and maintained blood-pressure control.</description><identifier>ISSN: 0149-2918</identifier><identifier>EISSN: 1879-114X</identifier><identifier>DOI: 10.1016/S0149-2918(03)80174-1</identifier><identifier>PMID: 12860503</identifier><language>eng</language><publisher>Belle Mead, NJ: EM Inc USA</publisher><subject>Adults ; Aged ; Aged, 80 and over ; amlodipine ; Amlodipine - administration & dosage ; Amlodipine - economics ; Amlodipine - therapeutic use ; angiotensin-converting enzyme inhibitor ; Angiotensin-Converting Enzyme Inhibitors - administration & dosage ; Angiotensin-Converting Enzyme Inhibitors - economics ; Angiotensin-Converting Enzyme Inhibitors - therapeutic use ; Antihypertensive agents ; antihypertensive therapy ; Antihypertensives ; benazepril ; Benzazepines - administration & dosage ; Benzazepines - economics ; Benzazepines - therapeutic use ; Biological and medical sciences ; Blood pressure ; calcium channel blocker ; Calcium Channel Blockers - administration & dosage ; Calcium Channel Blockers - economics ; Calcium Channel Blockers - therapeutic use ; Cardiovascular system ; Cost Savings ; Diabetes ; Drug Combinations ; Drug dosages ; Drug therapy ; drug-cost savings ; Enzymes ; Female ; fixed-dose combination ; Geriatrics ; Heart ; Humans ; Hypertension ; Hypertension - drug therapy ; Kidney diseases ; Long-Term Care ; Male ; Medical sciences ; Middle Aged ; Morbidity ; Mortality ; older adults (≥65 years) ; Older people ; Patients ; Pharmacology. Drug treatments ; Pilot Projects ; Quality Assurance, Health Care ; Treatment Outcome</subject><ispartof>Clinical therapeutics, 2003-06, Vol.25 (6), p.1872-1887</ispartof><rights>2003</rights><rights>2003 INIST-CNRS</rights><rights>Copyright Elsevier Limited Jun 2003</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-b08c760dfff2b1564d6c7e280afcedff2d3cb74ef7dfcd9c1359e21c8b2f5f4c3</citedby><cites>FETCH-LOGICAL-c419t-b08c760dfff2b1564d6c7e280afcedff2d3cb74ef7dfcd9c1359e21c8b2f5f4c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1032781226?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3548,27922,27923,45993,64383,64385,64387,72239</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14940888$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12860503$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sapienza, Salvatore</creatorcontrib><creatorcontrib>Sacco, Patricia</creatorcontrib><creatorcontrib>Floyd, Kristine</creatorcontrib><creatorcontrib>DiCesare, Joseph</creatorcontrib><creatorcontrib>Doan, QuynhChau Diem</creatorcontrib><title>Results of a pilot pharmacotherapy quality improvement program using fixed-dose, combination amlodipine/benazepril antihypertensive therapy in a long-term care setting</title><title>Clinical therapeutics</title><addtitle>Clin Ther</addtitle><description>Background: Hypertension is common in older adults (aged ≥65 years). Treatment frequently requires multiple medications and can be expensive.
Objective: This study measured the impact of substituting low-dose, fixed-combination therapy using the calcium channel blocker (CCB) amlodipine and the angiotensin-converting enzyme (ACE) inhibitor benazepril for high-dose CCB monotherapy or dual therapy with a CCB and an ACE inhibitor on antihypertensive drug costs, the incidence of adverse events, and blood-pressure control.
Methods: A multicenter, pilot pharmacotherapy quality improvement program was undertaken in a long-term care facility setting. Consultant pharmacists reviewed pharmacy records and medical charts from long-term care facilities, identifying older patients with a diagnosis of hypertension who either took CCB concomitantly with an ACE inhibitor or experienced adverse events on high-dose CCB therapy. Eligible patients were identified and their physicians contacted regarding switching them to fixed-dose combination therapy.
Results: A total of 51 patients at 17 facilities were switched to fixed-dose amlodipine/benazepril combination therapy; 94.1% were women and 5.9% were men (mean age, 85.1 years; range, 64–99 years). The mean number of comorbidities was 1.6. During the subsequent 2 months, mean blood pressure remained at levels similar to those at baseline. The number of patients reporting at least 1 drug-related adverse event decreased by 81.8% (
P < 0.05), and the incidence of edema decreased by 75.0%. The mean per-patient cost of antihypertensive drugs decreased by 33.1% (
P < 0.001), a mean per-patient savings of $19.21 per month.
Conclusion: In patients aged ≥65 years with hypertension in long-term care facilities, a change from high-dose CCB monotherapy or CCB/ACE-inhibitor dual therapy to fixed-dose combination amlodipine/benazepril therapy significantly reduced drug costs and the incidence of adverse events and maintained blood-pressure control.</description><subject>Adults</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>amlodipine</subject><subject>Amlodipine - administration & dosage</subject><subject>Amlodipine - economics</subject><subject>Amlodipine - therapeutic use</subject><subject>angiotensin-converting enzyme inhibitor</subject><subject>Angiotensin-Converting Enzyme Inhibitors - administration & dosage</subject><subject>Angiotensin-Converting Enzyme Inhibitors - economics</subject><subject>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</subject><subject>Antihypertensive agents</subject><subject>antihypertensive therapy</subject><subject>Antihypertensives</subject><subject>benazepril</subject><subject>Benzazepines - administration & dosage</subject><subject>Benzazepines - economics</subject><subject>Benzazepines - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Blood pressure</subject><subject>calcium channel blocker</subject><subject>Calcium Channel Blockers - administration & dosage</subject><subject>Calcium Channel Blockers - economics</subject><subject>Calcium Channel Blockers - therapeutic use</subject><subject>Cardiovascular system</subject><subject>Cost Savings</subject><subject>Diabetes</subject><subject>Drug Combinations</subject><subject>Drug dosages</subject><subject>Drug therapy</subject><subject>drug-cost savings</subject><subject>Enzymes</subject><subject>Female</subject><subject>fixed-dose combination</subject><subject>Geriatrics</subject><subject>Heart</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - drug therapy</subject><subject>Kidney diseases</subject><subject>Long-Term Care</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>older adults (≥65 years)</subject><subject>Older people</subject><subject>Patients</subject><subject>Pharmacology. Drug treatments</subject><subject>Pilot Projects</subject><subject>Quality Assurance, Health Care</subject><subject>Treatment Outcome</subject><issn>0149-2918</issn><issn>1879-114X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqF0d1qFDEUB_Agit1WH0EJSIuCY5NMZiZzJVL8goLgB3gXMsnJbspMMk0yi-sL-Zqm3dWCN14Fwu-ck5w_Qk8oeUUJbc-_EMr7ivVUPCf1C0Foxyt6D62o6PqKUv79Plr9JUfoOKUrQkjdN-whOqJMtKQh9Qr9-gxpGXPCwWKFZzeGjOeNipPSIW8gqnmHrxc1urzDbppj2MIEvpgY1lFNeEnOr7F1P8BUJiR4iXWYBudVdsFjNY3BuNl5OB_Aq58wRzdi5bPb7GaIGXxyW8B_BrlSgcfg11WGOGGtIuAEOZcRj9ADq8YEjw_nCfr27u3Xiw_V5af3Hy_eXFaa0z5XAxG6a4mx1rKBNi03re6ACaKshnLLTK2HjoPtjNWm17RuemBUi4HZxnJdn6Czfd_ywesFUpaTSxrGUXkIS5JdzXvSNV2Bz_6BV2GJvrxNUlKzTlDG2qKavdIxpBTByrKBScVdQfImR3mbo7wJSZJa3uYoaal7eui-DBOYu6pDcAWcHoBKWo02Kq9dunO850QIUdzrvYOytK2DKJN24MsyXASdpQnuP0_5DVufwA4</recordid><startdate>20030601</startdate><enddate>20030601</enddate><creator>Sapienza, Salvatore</creator><creator>Sacco, Patricia</creator><creator>Floyd, Kristine</creator><creator>DiCesare, Joseph</creator><creator>Doan, QuynhChau Diem</creator><general>EM Inc USA</general><general>Excerpta Medica</general><general>Elsevier Limited</general><scope>IQODW</scope><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>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20030601</creationdate><title>Results of a pilot pharmacotherapy quality improvement program using fixed-dose, combination amlodipine/benazepril antihypertensive therapy in a long-term care setting</title><author>Sapienza, Salvatore ; Sacco, Patricia ; Floyd, Kristine ; DiCesare, Joseph ; Doan, QuynhChau Diem</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c419t-b08c760dfff2b1564d6c7e280afcedff2d3cb74ef7dfcd9c1359e21c8b2f5f4c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adults</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>amlodipine</topic><topic>Amlodipine - administration & dosage</topic><topic>Amlodipine - economics</topic><topic>Amlodipine - therapeutic use</topic><topic>angiotensin-converting enzyme inhibitor</topic><topic>Angiotensin-Converting Enzyme Inhibitors - administration & dosage</topic><topic>Angiotensin-Converting Enzyme Inhibitors - economics</topic><topic>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</topic><topic>Antihypertensive agents</topic><topic>antihypertensive therapy</topic><topic>Antihypertensives</topic><topic>benazepril</topic><topic>Benzazepines - administration & dosage</topic><topic>Benzazepines - economics</topic><topic>Benzazepines - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Blood pressure</topic><topic>calcium channel blocker</topic><topic>Calcium Channel Blockers - administration & dosage</topic><topic>Calcium Channel Blockers - economics</topic><topic>Calcium Channel Blockers - therapeutic use</topic><topic>Cardiovascular system</topic><topic>Cost Savings</topic><topic>Diabetes</topic><topic>Drug Combinations</topic><topic>Drug dosages</topic><topic>Drug therapy</topic><topic>drug-cost savings</topic><topic>Enzymes</topic><topic>Female</topic><topic>fixed-dose combination</topic><topic>Geriatrics</topic><topic>Heart</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - drug therapy</topic><topic>Kidney diseases</topic><topic>Long-Term Care</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>older adults (≥65 years)</topic><topic>Older people</topic><topic>Patients</topic><topic>Pharmacology. Drug treatments</topic><topic>Pilot Projects</topic><topic>Quality Assurance, Health Care</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sapienza, Salvatore</creatorcontrib><creatorcontrib>Sacco, Patricia</creatorcontrib><creatorcontrib>Floyd, Kristine</creatorcontrib><creatorcontrib>DiCesare, Joseph</creatorcontrib><creatorcontrib>Doan, QuynhChau Diem</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sapienza, Salvatore</au><au>Sacco, Patricia</au><au>Floyd, Kristine</au><au>DiCesare, Joseph</au><au>Doan, QuynhChau Diem</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Results of a pilot pharmacotherapy quality improvement program using fixed-dose, combination amlodipine/benazepril antihypertensive therapy in a long-term care setting</atitle><jtitle>Clinical therapeutics</jtitle><addtitle>Clin Ther</addtitle><date>2003-06-01</date><risdate>2003</risdate><volume>25</volume><issue>6</issue><spage>1872</spage><epage>1887</epage><pages>1872-1887</pages><issn>0149-2918</issn><eissn>1879-114X</eissn><abstract>Background: Hypertension is common in older adults (aged ≥65 years). Treatment frequently requires multiple medications and can be expensive.
Objective: This study measured the impact of substituting low-dose, fixed-combination therapy using the calcium channel blocker (CCB) amlodipine and the angiotensin-converting enzyme (ACE) inhibitor benazepril for high-dose CCB monotherapy or dual therapy with a CCB and an ACE inhibitor on antihypertensive drug costs, the incidence of adverse events, and blood-pressure control.
Methods: A multicenter, pilot pharmacotherapy quality improvement program was undertaken in a long-term care facility setting. Consultant pharmacists reviewed pharmacy records and medical charts from long-term care facilities, identifying older patients with a diagnosis of hypertension who either took CCB concomitantly with an ACE inhibitor or experienced adverse events on high-dose CCB therapy. Eligible patients were identified and their physicians contacted regarding switching them to fixed-dose combination therapy.
Results: A total of 51 patients at 17 facilities were switched to fixed-dose amlodipine/benazepril combination therapy; 94.1% were women and 5.9% were men (mean age, 85.1 years; range, 64–99 years). The mean number of comorbidities was 1.6. During the subsequent 2 months, mean blood pressure remained at levels similar to those at baseline. The number of patients reporting at least 1 drug-related adverse event decreased by 81.8% (
P < 0.05), and the incidence of edema decreased by 75.0%. The mean per-patient cost of antihypertensive drugs decreased by 33.1% (
P < 0.001), a mean per-patient savings of $19.21 per month.
Conclusion: In patients aged ≥65 years with hypertension in long-term care facilities, a change from high-dose CCB monotherapy or CCB/ACE-inhibitor dual therapy to fixed-dose combination amlodipine/benazepril therapy significantly reduced drug costs and the incidence of adverse events and maintained blood-pressure control.</abstract><cop>Belle Mead, NJ</cop><pub>EM Inc USA</pub><pmid>12860503</pmid><doi>10.1016/S0149-2918(03)80174-1</doi><tpages>16</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0149-2918 |
| ispartof | Clinical therapeutics, 2003-06, Vol.25 (6), p.1872-1887 |
| issn | 0149-2918 1879-114X |
| language | eng |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present); ProQuest Central UK/Ireland |
| subjects | Adults Aged Aged, 80 and over amlodipine Amlodipine - administration & dosage Amlodipine - economics Amlodipine - therapeutic use angiotensin-converting enzyme inhibitor Angiotensin-Converting Enzyme Inhibitors - administration & dosage Angiotensin-Converting Enzyme Inhibitors - economics Angiotensin-Converting Enzyme Inhibitors - therapeutic use Antihypertensive agents antihypertensive therapy Antihypertensives benazepril Benzazepines - administration & dosage Benzazepines - economics Benzazepines - therapeutic use Biological and medical sciences Blood pressure calcium channel blocker Calcium Channel Blockers - administration & dosage Calcium Channel Blockers - economics Calcium Channel Blockers - therapeutic use Cardiovascular system Cost Savings Diabetes Drug Combinations Drug dosages Drug therapy drug-cost savings Enzymes Female fixed-dose combination Geriatrics Heart Humans Hypertension Hypertension - drug therapy Kidney diseases Long-Term Care Male Medical sciences Middle Aged Morbidity Mortality older adults (≥65 years) Older people Patients Pharmacology. Drug treatments Pilot Projects Quality Assurance, Health Care Treatment Outcome |
| title | Results of a pilot pharmacotherapy quality improvement program using fixed-dose, combination amlodipine/benazepril antihypertensive therapy in a long-term care setting |
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