Simonyi Gábor, Ferenci Tamás, Medvegy Mihály, Gasparics Roland, Finta Ervin
Anyagcsere Központ, Szent Imre Egyetemi Oktatókórház Budapest, Tétényi út 12-16., 1115.
Neumann János Informatikai Kar, Élettani Szabályozások Csoport, Óbudai Egyetem Budapest.
Orv Hetil. 2017 Sep;158(36):1421-1425. doi: 10.1556/650.2017.30851.
In management of hypertension patient adherence is one of the most important factors. In hypertension the cardiovascular risk reduction can be reached only by prolonged and effective pharmacotherapy.
To evaluate the persistence of one-year treatment of free and fixed-dose combination of perindopril/amlodipine in hypertension.
Information from the National Health Insurance of Hungary prescriptions database on pharmacy claims between October 1, 2012 and September 30, 2013 was analysed. Authors identified patients who filled prescriptions for free and fixed-dose combination of perindopril/amlodipine, prescribed for the first time for hypertension. Patients have not received antihypertensive therapy with similar active substances during the one year before. Apparatus of survival analysis was used, where "survival" was the time to abandon the medication. As it was available to month precision, discrete time survival analysis was applied.
109,248 patients met the inclusion criteria. Combination antihypertensive therapy with perindopril/amlodipine was started with a free or a fixed-dose combination of these agents in 19,365 and 89,883 patients, respectively. One year persistence rate in patients taking perindopril/amlodipine as a free combination was 27.15%, whereas it was 46.89% in those on the fixed-dose combination. Mean duration of persistence was 177.6 days in patients on the perindopril/amlodipine free, whereas 245.7 days on fixed-dose combination. Actual rate of discontinuation was approximately twice higher with the treatment of free, compared with the use of the fixed-dose combination (hazard ratio =1.94 [95% CI: 1.91-1.98], p<0.001). Orv Hetil. 2017; 158(36): 1421-1425.
在高血压管理中，患者依从性是最重要的因素之一。在高血压治疗中，只有通过长期有效的药物治疗才能降低心血管风险。
评估培哚普利/氨氯地平自由组合和固定剂量组合治疗高血压一年的持续性。
分析了匈牙利国家健康保险处方数据库中2012年10月1日至2013年9月30日期间药房索赔的信息。作者确定了首次因高血压开具培哚普利/氨氯地平自由组合和固定剂量组合处方的患者。这些患者在之前一年未接受过含类似活性物质的抗高血压治疗。采用生存分析方法，其中“生存”时间为停药时间。由于精确到月，应用离散时间生存分析。
109248例患者符合纳入标准。分别有19365例和89883例患者开始使用培哚普利/氨氯地平自由组合和固定剂量组合进行联合抗高血压治疗。服用培哚普利/氨氯地平自由组合的患者一年持续率为27.15%，而服用固定剂量组合的患者为46.89%。服用培哚普利/氨氯地平自由组合的患者持续时间平均为177.6天，而服用固定剂量组合的患者为245.7天。与固定剂量组合相比，自由组合治疗的实际停药率约高出两倍（风险比=1.94[95%CI：1.91-1.98]，p<0.001）。《匈牙利医学周报》。2017年；158(36)：1421-1425。
