ArticleBMJ open2019
Effects of combination drugs on antihypertensive medication adherence in a real-world setting: a Korean Nationwide Study.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Medication adherence with fixed-doseFrontiers in pharmacology · 2023Pooled it
- Continuing versus withholding angiotensin receptor blocker (ARB)/calcium channel blocker (CCB) combination tablets during perioperative periods in patients undergoing minor surgery: a single-blinded randomized controlled trial.Journal of anesthesia · 2022Trial
- "I must, and I can live with that": a thematic analysis of patients' perspectives on polypharmacy and a digital decision support system for GPs.BMC family practice · 2021Trial
- Prevalence and factors influencing medication adherence after acute myocardial infarction: a systematic review and meta-analysis.International journal of clinical pharmacy · 2026Review
- Contacts to general practitioners and renewal of antihypertensive medication - a four-year follow-up in primary health care, Turku, Finland.BMC primary care · 2025Article
- Five-year follow-up with the incidence of cardiovascular adverse events after prescribing single-pill combination of antihypertensive drugs: retrospective cohort study.Journal of pharmaceutical health care and sciences · 2025Article
- LASSO logistic regression and cluster analysis in predicting adherence and drug patterns among new users of monotherapy for antihypertensive drugs.Journal of hypertension · 2025Article
- Understanding Treatment Adherence in Chronic Diseases: Challenges, Consequences, and Strategies for Improvement.Journal of clinical medicine · 2025Review
- Bioequivalence Study of Two Oral Methocarbamol Formulations in Healthy Subjects Under Fasting Conditions: A Randomized, Open-Label, Crossover Clinical Trial.Pharmaceuticals (Basel, Switzerland) · 2025Article
- Assessing Readability and Usability of Electronic Medicine Package Leaflets in South Korea: A Mixed-Methods Study.Drug, healthcare and patient safety · 2025Article
- Is Satisfaction with the Medication Provisions of the Senior Citizens Act and Frequency of Senior Identification Card Use Associated with Medication Compliance among Hypertensive Patients in the Philippines?Acta medica Philippina · 2025Article
- Effect of Comprehensive Health Management on Medication Adherence and Healthy Lifestyle Behavior of Patients With Hypertension.International journal of hypertension · 2025Article
- Review
- Overcoming Low Adherence to Chronic Medications by Improving their Effectiveness using a Personalized Second-generation Digital System.Current pharmaceutical biotechnology · 2024Review
- Interventions for Adherence Improvement in the Primary Prevention of Cardiovascular Diseases: Expert Consensus Statement.Korean circulation journal · 2022Review
- Polypharmacy, chronic kidney disease, and incident fragility fracture: a prospective cohort study.Journal of bone and mineral metabolism · 2022Article
- Expanding role for single-pill combination drug therapy in the initial treatment of hypertension?Journal of clinical hypertension (Greenwich, Conn.) · 2021Article
- Strategies to Improve Adherence to Anti-Hypertensive Medications: a Narrative Review.Current hypertension reports · 2020Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWe tried to clarify, by using representative national data in a real-world setting, whether single-pill combinations (SPCs) of antihypertensives actually improve medication adherence.
designA nationwide population-based study.
settingWe used a 2.2% cohort (n=1 048 061) of the total population (n=46 605 433) that was randomly extracted by National Health Insurance of Korea from 2008 to 2013.
participantsWe included patients (n=116 677) who were prescribed with the same antihypertensive drugs for at least 1 year and divided them into groups of angiotensin II receptor blocker (ARB)-only, calcium channel blocker (CCB)-only, multiple-pill combinations (MPCs) and SPCs of ARB/CCB. PRIMARY OUTCOME MEASURES: Medication possession ratio (MPR), a frequently used indirect measurement method of medication adherence.
resultsAdjusted MPR was higher in combination therapy (89.7% in SPC, 87.2% in MPC) than monotherapy (81.6% in ARB, 79.7% in CCB), and MPR of SPC (89.7%, 95% CI 89.3 to 90.0) was higher than MPR of MPC (87.2%, 95% CI 86.7 to 87.7) (p<0.05). In subgroup analysis, adherence of SPC and MPC was 92.3% (95% CI 91.5 to 93.0) vs 88.1% (95% CI 87.1 to 89.0) in those aged 65-74 years and 89.3% (95% CI 88.0 to 90.7) vs 84.8% (95% CI 83.3 to 92.0) in those ≥75 years (p<0.05). According to total pill numbers, adherence of SPC and MPC was 90.9% (CI 89.8 to 92.0) vs 85.3% (95% CI 84.1 to 86.5) in seven to eight pills and 91.2% (95% CI 89.3 to 93.1) vs 82.5% (95% CI 80.6 to 84.4) in nine or more (p<0.05). The adherence difference between SPC and MPC started to increase at five to six pills and at age 50-64 years (p<0.05). When analysed according to elderly status, the adherence difference started to increase at three to four pills in the elderly (≥65 years) and at five to six in the non-elderly group (20-64 years) (p<0.05). These differences all widened further with increasing age and the total medications.
conclusionSPC regimens demonstrated higher adherence than MPC, and this tendency is more pronounced with increasing age and the total number of medications.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.