University of Bologna, IRCCS Ospedale S. Orsola, Bologna, Italy.
Lakshmi Hospital, Palakkad, India.
Adv Ther. 2023 Apr;40(4):1765-1772. doi: 10.1007/s12325-023-02451-y. Epub 2023 Feb 24.
Single-pill combination therapy for hypertension is recognized to improve adherence to treatment. However, less is known about the benefits of triple single-pill combinations. This retrospective observational analysis aimed to assess changes in adherence when treatment was switched from perindopril (PER)/indapamide (IND) + amlodipine (AML) to PER/IND/AML single-pill combination, in Italian clinical practice.
This analysis used data extracted from administrative databases of Italian healthcare entities. Adult patients receiving PER/IND/AML were selected, and the prescription date was considered as the index date. Among them, those who had a prescription for PER/IND + AML during the 12 months before the index date and a prescription of PER/IND/AML during 6 months of follow-up were included. Adherence was calculated as the proportion of days covered (PDC: PDC < 40%, non-adherent; PDC = 40-79%, partially adherent; PDC ≥ 80%, adherent).
Among the identified patients, 158 were exposed users and were included in the analysis. When patients were compared before and after switch to triple single-pill combination, the proportion of adherent patients was significantly higher with PER/IND/AML single-pill combination (75.3%) than with PER/IND + AML combination (44.3%) (P < 0.05). Conversely, the proportion of non-adherent patients was lower with the PER/IND/AML single-pill combination (14.6%) vs PER/IND + AML (17.7%) (P < 0.001).
This real-world analysis showed that switching to a triple single-pill combination could offer an opportunity to improve adherence to antihypertensive treatment in real-life clinical practice.
高血压的单片复方制剂治疗被认为可提高治疗的依从性。然而,对于三联单片复方制剂的益处了解较少。本回顾性观察性分析旨在评估意大利临床实践中,将培哚普利(PER)/吲达帕胺(IND)+氨氯地平(AML)治疗方案转换为培哚普利/吲达帕胺/氨氯地平单片复方制剂时,治疗依从性的变化情况。
本分析使用了来自意大利医疗机构行政数据库的数据。选择接受培哚普利/吲达帕胺/氨氯地平治疗的成年患者,并将处方日期视为索引日期。其中,在索引日期前 12 个月内有培哚普利/吲达帕胺+氨氯地平处方,且在随访 6 个月内有培哚普利/吲达帕胺/氨氯地平处方的患者被纳入分析。依从性以用药天数比例(PDC:PDC<40%,不依从;PDC=40-79%,部分依从;PDC≥80%,依从)来计算。
在所识别的患者中,有 158 名暴露使用者被纳入分析。与转换为三联单片复方制剂之前相比,转换为培哚普利/吲达帕胺/氨氯地平单片复方制剂后,依从患者的比例显著更高(75.3% vs 44.3%,P<0.05)。相反,不依从患者的比例更低(14.6% vs 17.7%,P<0.001)。
这项真实世界研究表明,转换为三联单片复方制剂可能为改善真实世界临床实践中抗高血压治疗的依从性提供机会。