St Vincent's Hospital, University of New South Wales, Sydney, NSW, Australia.
Med J Aust. 2011 Aug 1;195(3):134-7. doi: 10.5694/j.1326-5377.2011.tb03240.x.
To study patient persistence on therapy for hypertension and dyslipidaemia using a single-pill combination compared with a two-pill approach.
Post-hoc observational assessment of Pharmaceutical Benefits Scheme claim records covering the period April 2005 to March 2010.
A 10% random sample of Australian long-term concession card holders was analysed. The patients studied had commenced on either amlodipine and atorvastatin as two individual pills, or a single pill containing both amlodipine and atorvastatin (AA), with neither combined approach having been dispensed to them in the previous 6 months.
The proportions of patients failing to fill their first repeat prescription after 1 month or failing to persist with treatment at 12 months, and the median persistence time (MPT) were measured.
Of 4146 patients prescribed the AA single pill, 11% failed to fill the first repeat prescription and 33% had ceased treatment by 12 months (MPT, 35 months). Of 6204 patients prescribed amlodipine and atorvastatin as two pills, 23% failed to fill the first repeat prescriptions and 59% had ceased treatment by 12 months (MPT, 7 months). In a multivariate model, cessation of single-pill therapy increased by 165% if there was no prior therapy, but only increased by 48%-55% if there was no prior therapy with a calcium channel blocker or statin. MPT on the single pill was 8 months in those without prior antihypertensive therapy, but was ≥ 37 months in those with any prior antihypertensive therapy.
A single-pill combination drug is associated with superior long-term persistence compared with two-pill therapy in the management of hypertension and dyslipidaemia.
研究与两药方案相比，使用单片复方制剂治疗高血压和血脂异常的患者持续用药情况。
对 2005 年 4 月至 2010 年 3 月期间药品福利计划索赔记录的事后观察性评估。
分析了澳大利亚长期优惠卡持有者的 10%随机样本。研究对象开始服用氨氯地平和阿托伐他汀两种单独的药丸，或者服用含有氨氯地平和阿托伐他汀的单片复方制剂（AA），在过去 6 个月内都没有同时开这两种药物。
测量患者在 1 个月时未能首次续方的比例、在 12 个月时停药的比例，以及中位持续时间（MPT）。
在接受 AA 单药治疗的 4146 例患者中，有 11%的患者未能首次续方，33%的患者在 12 个月时停止治疗（MPT 为 35 个月）。在接受氨氯地平和阿托伐他汀两种药物治疗的 6204 例患者中，有 23%的患者未能首次续方，59%的患者在 12 个月时停止治疗（MPT 为 7 个月）。在多变量模型中，如果没有既往治疗，单一药物治疗的停药风险增加 165%，但如果没有钙通道阻滞剂或他汀类药物的既往治疗，停药风险仅增加 48%-55%。如果没有既往抗高血压治疗，单片药物的 MPT 为 8 个月，但如果有任何既往抗高血压治疗，MPT 则≥37 个月。
与两药方案相比，在高血压和血脂异常的治疗中，单片复方制剂药物具有更高的长期持续治疗率。
