ArticleBMJ open2016
Comparison of therapy persistence for fixed versus free combination antihypertensives: a retrospective cohort study.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The impact of fixed-dose combination versus free-equivalent combination therapies on adherence for hypertension: a meta-analysis.Journal of clinical hypertension (Greenwich, Conn.) · 2018Pooled it
- Effect of a single pill concept on clinical and pharmacoeconomic outcomes in cardiovascular diseases.European heart journal. Cardiovascular pharmacotherapy · 2025Observational
- Prevention is the key.European heart journal. Cardiovascular pharmacotherapy · 2025Article
- Blood pressure-lowering medication prescribing, its adherence to guidelines and relationship with blood pressure control at a family medicine department.Health science reports · 2023Article
- Effects of Single Pill Combinations Compared to Identical Multi Pill Therapy on Outcomes in Hypertension, Dyslipidemia and Secondary Cardiovascular Prevention: The START-Study.Integrated blood pressure control · 2022Article
- Effect of patient and treatment factors on persistence with antihypertensive treatment: A population-based study.PloS one · 2021Observational
- Therapeutic Compliance of Patients with Arterial Hypertension in Primary Care.Medicina (Kaunas, Lithuania) · 2020Article
- Comparison of Efficacies of Commonly Used Hypertension Treatment Modalities: A Retrospective Study of 1900 Participants in a Hypertension Clinic.Medical science monitor : international medical journal of experimental and clinical research · 2020Article
- Fixed Versus Free Combinations Of Antihypertensive Drugs: Analyses Of Real-World Data Of Persistence With Therapy In Italy.Patient preference and adherence · 2019Article
- Starting a Fixed-Dose Combination Pill versus a Single Agent for Patients with Hypertension.Journal of general internal medicine · 2017Article
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe aim of the study was to compare therapy persistence among patients who started with one of three drug regimens: a monotherapy, or combination therapy either as a fixed combination (ie, 'single pill') or as a free combination (ie, two separate antihypertensive agents).
designIn a secondary data analysis, we used descriptive statistics and multivariate logistic regression to measure the effect of the three therapy regimens on therapy persistence over 4 years.
settingPrescription data from a large German statutory health insurance provider.
participantsAll patients who started with a new antihypertensive therapy in 2007 or 2008 (n=8032) were included and followed for 4 years. PRIMARY OUTCOME MEASURE: Therapy persistence, defined as receiving a refill prescription no later than within 180 days.
resultsThe persistence rates after 4 years were nearly identical among patients who started with a monotherapy (40.3%) or a fixed combination of two drugs (39.8%). However, significantly more patients who started with free-drug combinations remained therapy persistent (56.4%), resulting in an OR of 2.00 (95% CI 1.6 to 2.5; p<0.0001) for free combinations versus fixed combinations. This trend was observed in all age groups and for men and women. At the end of the study period, the number of different antihypertensive agents was still similar between patients who started with a fixed combination (2.41) and patients who started with a free combination (2.28).
conclusionsWhile single-pill combinations make it easier to take different drugs at once, the risk is high that these several substances are stopped at once. Therapy persistence was significantly better for patients who started with a free-drug combination without taking much fewer different antihypertensive drugs as those with a fixed combination.
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