Secular Trends in Prescription Patterns of Single-Pill Combinations of an Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Plus a Thiazide Diuretic for Hypertensive Patients in Taiwan.

Chih-Neng Hsu, Tzung-Dau Wang

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Article in Acta Cardiologica Sinica, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

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7citing papers in PubMed

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3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

The feasibility of polypill for cardiovascular disease prevention in Asian Population.Journal of clinical hypertension (Greenwich, Conn.) · 2021
Review
Asian management of hypertension: Current status, home blood pressure, and specific concerns in Taiwan.Journal of clinical hypertension (Greenwich, Conn.) · 2020
Review
Systematic Review with Network Meta-Analysis: Comparative Efficacy and Safety of Combination Therapy with Angiotensin II Receptor Blockers and Amlodipine in Asian Hypertensive Patients.International journal of hypertension · 2019
Article
Clinical outcomes in hypertensive patients treated with a single-pill fixed-dose combination of renin-angiotensin system inhibitor and thiazide diuretic.Journal of clinical hypertension (Greenwich, Conn.) · 2018
Article
The Application and Future of Big Database Studies in Cardiology: A Single-Center Experience.Acta Cardiologica Sinica · 2017
Review
Medication compliance and clinical outcomes of fixed-dose combinations vs free combinations of an angiotensin II receptor blocker and a calcium channel blocker in hypertension treatment.Journal of clinical hypertension (Greenwich, Conn.) · 2017
Article
Fixed-Dose Combinations of Renin-Angiotensin System Inhibitors and Calcium Channel Blockers in the Treatment of Hypertension: A Comparison of Angiotensin Receptor Blockers and Angiotensin-Converting Enzyme Inhibitors.Medicine · 2015
Observational

4 · The record

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5 · Who and what money

Authors and funding

2 authors.

Chih-Neng HsuCardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Yun-lin Branch, Yun-lin, Taiwan;

Tzung-Dau WangCardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPoor adherence to recommended drug regimens is one of the fundamental issues behind suboptimal control rates of hypertension worldwide. Single-pill combinations (SPCs) improve patient adherence, decrease cost, and are increasingly prescribed in the Western societies. We conducted this study to elucidate the prescription patterns and the secular trends of SPCs in Taiwan.

methodsWe retrospectively reviewed the reimbursement database of Taiwan's National Health Insurance from 2002 to 2007. Among the one million-person random samples, information from those coded with ICD-9 401-405 and antihypertensive prescriptions was obtained.

resultsFrom 2002 to 2007, there had been amore than 7.5-fold increase in annual prescription frequency of SPCs of an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) plus a thiazide diuretic (from 1.1% to 8.5%, p < 0.001) among 302,628 hypertensive patients. Likewise, among patients treated with at least ACEIs or ARBs and diuretics, the relative proportion of SPC use, in contrast to free combinations, increased markedly (from 10.8% to 54.2%, p = 0.005). Incorporating patient antihypertensive treatment prior to SPCs prescription,we categorized the SPC prescription patterns into 3 groups: naïve, switch, and add-on. The increase in patients taking SPCs came mostly from the naïve SPC prescription group (from 2.3% in 2002 to 28.8% in 2007 among all patients treated with ACEIs or ARBs and thiazide diuretics, p = 0.003). Compared to both naïve and add-on SPC users, patients in the switch group had a greater pill burden and more comorbidities, whichmight drive physicians to switch from free combinations to SPCs.

conclusionsSingle-pill combinations are well-accepted and increasingly prescribed in Taiwan, particularly in drug-naïve hypertensive patients. This finding might indicate an aggressive attitude towards early hypertension control among physicians in Taiwan. KEY WORDS: Angiotensin-converting enzyme inhibitor; Angiotensin receptor blocker; Diuretic; Hypertension; Single-pill combinations.

Identifiers

PMID27122684

PMCPMC4804960

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