Comparison of medication adherence between fixed-dose combination of angiotensin receptor blockers and statin and free-combination therapy

Abstract

Abstract Background Non-adherence to angiotensin receptor blockers (ARB) or statin is one of major reasons of insufficient treatment for patients with hyperlipidemia and hypertension. We investigated whether fixed-dose combination (FDC) of ARB and statin improved adherence compared to traditional free combination (FC). Methods In this retrospective nationwide cohort study, adherence of 128,369 patients who started ARB and stain including atorvastatin or rosuvastatin between July 2014 and June 2015 was investigated. Primary endpoint was proportion of days covered (PDC) per 180 days up to day 540. Good compliance defined by PDC≥80% and persistency rate defined by patients remaining on medication were also investigated. Results Patients were 62.9 years of mean age with 48.2% female gender. Compared to FC (N=90,759, 70.7%), FDC (N=37,610, 29.3%) showed higher PDC at day 180 (86% vs 70%), 360 (77% vs 62%), and 540 (74% vs 55%, p<0.001, all). Frequency of patients with PDC≥80% was also higher in FDC compared to FC at day 180 (80.1% vs 51.8%), 360 (71.7% vs 54.2%), and 540 (69.2% vs 49.3%, p<0.001, all). Persistency rate at day 540 was higher in FDC compared to FC (50.4% vs 27.3%, p<0.001). The mean decline in PDC per 180 days were significantly lower in FDC compared to FC per 180 days (6.0% vs. 7.5%, p<0.001). Conclusions In this real-world data analysis, FDC resulted in higher medication adherence and persistence compared to FC among patients who started both ARB and atorvastatin or rosuvastatin. Persistence rate btw FDC and FC Funding Acknowledgement Type of funding source: None