Boston—Patients prescribed an all-in-one pill as their initial medication for high blood pressure appear to be at an advantage when it comes to adherence.
A study in the Journal of General Internal Medicine suggests the combination pill makes it more likely that patients will follow their drug regimen in the long run.
For the study, Brigham and Women’s Hospital and Harvard Medical School researchers analyzed data from claims submitted to a large national health insurer between 2009 and 2013, focusing on patients who had started using antihypertensive medication during that time. The data showed that 78,958 of the patients in the sample of 484,493 initially were prescribed fixed-dose combinations—i.e., a single pill containing multiple drugs—while 383,269 were prescribed a single therapy and 22,266 were on multi-pill combinations.
The study’s primary outcome was persistence with any anti-hypertensive medication, either the initiated medication or other anti-hypertensive, 12 months after a prescription first showed up in administrative claims. Other outcomes included sticking with at least one antihypertensive in the 12 months after initiation and refilling at least one antihypertensive medication, with full adherence defined as having 80% or more of potential days covered with medication.
Results indicate that patients on fixed-dose combinations were 9% more likely to be adherent to blood pressure medication and were 13% more likely to regularly use the treatment prescribed for them than were patients who began using single anti-hypertensive therapy.
Other findings included:
• Patients who started off on single therapies or multipill combinations were generally sicker and more likely to require further medical help than those on fixed-dose combinations.
• Patients on single therapies or multipill combinations also were slightly less likely to refill their prescriptions.
• On the other hand, those being prescribed fixed-dose combinations were generally older and female.
Study authors conclude, “Fixed-dose combination pills appear to enhance adherence and persistence to anti-hypertensive medications among commercially insured patients starting treatment compared with single therapy.”
Lead author Julie Lauffenburger, PharmD, PhD, added, “For patients beginning anti-hypertensive treatment, clinicians may therefore want to consider starting patients on a fixed-dose combination pill rather than a single therapy.”
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