Open AccessThe impact of fixed‐dose combination versus free‐equivalent combination therapies on adherence for hypertension: a meta‐analysis
Author(s) -
Du LiPing,
Cheng ZhongWei,
Zhang YuXuan,
Li Ying,
Mei Dan
Publication year - 2018
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.13272
Subject(s) - medicine , confidence interval , meta analysis , fixed dose combination , combination therapy , medication adherence , medline , blood pressure , political science , law
Nonadherence to antihypertensive medication is considered as a reason of inadequate control of blood pressure. This meta‐analysis aimed to systemically evaluate the impact of fixed‐dose combination ( FDC ) therapy on hypertensive medication adherence compared with free‐equivalent combination therapies. Articles were retrieved from MEDLINE and Embase databases using a combination of terms “fixed‐dose combinations” and “adherence or compliance or persistence” and “hypertension or antihypertensive” from January 2000 to June 2017 without any language restriction. A meta‐analysis was performed to parallel compare the impact of FDC vs free‐equivalent combination on medicine adherence or persistence. Studies were independently reviewed by two investigators. Data from eligible studies were extracted and a meta‐analysis was performed using R version 3.1.0 software. A total of nine studies scored as six of nine to eight of nine for Newcastle‐Ottawa rating with 62 481 patients with hypertension were finally included for analysis. Results showed that the mean difference of medication adherence for FDC vs free‐equivalent combination therapies was 14.92% (95% confidence interval, 7.38%–22.46%). Patients in FDC group were more likely to persist with their antihypertensive treatment, with a risk ratio of 1.84 (95% confidence interval, 1.00–3.39). This meta‐analysis confirmed that FDC therapy , compared with free‐equivalent combinations, was associated with better medication adherence or persistence for patients with hypertension. It can be reasonable for physicians, pharmacists, and policy makers to facilitate the use of FDC s for patients who need to take two or more antihypertensive drugs.