Single-Pill vs Free-Equivalent Combination Therapies for Hypertension: A Meta-Analysis of Health Care Costs and Adherence
Single-Pill vs Free-Equivalent Combination Therapies for Hypertension: A Meta-Analysis of Health Care Costs and Adherence
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DOI：
10.1111/j.1751-7176.2011.00550.x
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发表时间：
2011-12-01
影响因子：
2.8
通讯作者：
Panjabi, Sumeet
中科院分区：
文献类型：
--
作者：
Sherrill, Beth;Halpern, Michael;Panjabi, Sumeet
这项荟萃分析比较了基于对已发表研究的结构性回顾，服用抗高血压药物作为单药组合（SPC）与免费等效成分（FEC）的患者组之间的医疗资源使用成本，依从性和持久性。检索得到12项纳入分析的回顾性数据库研究。SPC组每年全因和高血压相关医疗费用的平均差异为1357美元（95%置信区间[CI]，778- 1935美元），低于FEC组。与相应的FEC患者相比，既往未接受过抗高血压药物治疗的患者的依从性（以药物拥有率的平均差异衡量）估计高出8%，非首次接受过抗高血压药物治疗的SPC患者高出14%。SPC组的持续性是FEC组的两倍（合并风险比，2.1; 95%CI，1.1-4.1）。通过改善临床结局，改善依从性和持久性可能有助于降低SPC组的成本。临床高血压杂志（格林威治）。2011; 13：898-909. (C)2011 Wiley Periodicals，Inc.
This meta-analysis compares health care resource use costs, adherence, and persistence between groups of patients taking antihypertensives as single-pill combinations (SPCs) vs free-equivalent components (FEC) based on a structured review of published studies. The search yielded 12 retrospective database studies included in analyses. The mean difference in combined total annual all-cause and hypertension-related health care costs was $ 1357 (95% confidence interval [CI], $ 778-$ 1935) lower in favor of SPC than FEC groups. Adherence, measured as the mean difference in medication possession ratio, was estimated to be 8% higher for patients naive to prior antihypertensives and 14% higher for nonnaive SPC patients compared with corresponding FEC patients. Persistence in the SPC groups was twice as likely as the FEC groups (pooled risk ratio, 2.1; 95% CI, 1.1-4.1). Improved adherence and persistence may have contributed to the lower costs in the SPC groups via improved clinical outcomes. J Clin Hypertens (Greenwich). 2011; 13: 898-909. (C) 2011 Wiley Periodicals, Inc.