Pan Feng, Chernew Michael E, Fendrick A Mark
Department of Health Management and Policy, University of Michigan, Ann Arbor, MI, USA.
J Gen Intern Med. 2008 May;23(5):611-4. doi: 10.1007/s11606-008-0544-x. Epub 2008 Feb 21.
The inverse correlation between the complexity of a drug regimen and medication adherence is well established. Fixed-dose combination (FDC) therapies are hypothesized to enhance compliance by decreasing the number of required pills.
The objective of the study is to compare adherence of a FDC [Glucovance, a FDC of metformin and glyburide] to a 2-pill regimen.
Longitudinal data from a large claims database were used to assess adherence from January 1, 2000, to December 31, 2001. Propensity scoring methods were used to mitigate concerns related to non-random assignment of patients to treatments.
The subjects of the study were individuals prescribed metformin or sulfonylurea or both before July 2000, who were prescribed both metformin and sulfonylurea concurrently (either separately or FDC) after August 2000.
Adherence was measured by medication possession ratio; the proportion of days on which a patient had medication available.
The FDC enhanced adherence rates by approximately 13% when compared to a 2-pill regimen.
Compared to 2-pill therapy, a FDC resulted in important increases in patient adherence. Economic analyses are warranted to determine whether the clinical benefits attributable to the adherence gains are worth the incremental cost of a FDC.
药物治疗方案的复杂性与药物依从性之间的负相关关系已得到充分证实。固定剂量复方（FDC）疗法被认为可通过减少所需药片数量来提高依从性。
本研究的目的是比较一种FDC（格华止，二甲双胍和格列本脲的FDC）与两片剂方案的依从性。
利用大型索赔数据库中的纵向数据评估2000年1月1日至2001年12月31日期间的依从性。倾向评分方法用于减轻与患者非随机分配治疗相关的担忧。
研究对象为2000年7月前开具二甲双胍或磺脲类药物或两者处方，2000年8月后同时开具二甲双胍和磺脲类药物（单独或FDC）的个体。
通过药物持有率衡量依从性；即患者有可用药物的天数比例。
与两片剂方案相比，FDC使依从率提高了约13%。
与两片剂治疗相比，FDC可显著提高患者依从性。有必要进行经济分析，以确定依从性提高带来的临床益处是否值得FDC增加的成本。
