P4561Patients adherence with fixed dose combinations of renin-angiotensin-aldosterone system inhibitors in hypertension

Abstract

Abstract Introduction The latest ESC/ESH guidelines recommended fixed dose combinations (FDC) for first therapy in hypertension. Preferred two-drug combinations are a RAS (renin–angiotensin system) blocker with a CCBs (calcium channel blockers) or a diuretic. There are no available data about these FDCs adherence in hypertension. Aim To assess one year persistence of recommended FDCs (RAS-inhibitors/CCBs or diuretics) in hypertensive patients. Method Prescriptions database of National Health Insurance Found in Hungary on pharmacy-claims were analysed between October 1, 2012 and September 30, 2013. We identified patients who filled prescriptions for FDCs of RAS-inhibitors/CCBs or diuretics prescribed for the first time in hypertensive patients who have not received similar drugs during one year before. To model the persistence, the apparatus of survival analysis was used, where “survival” was the time to abandon the medication. Results 443,149 patients met the inclusion criteria. One-year persistence rate and hazard ratio (HR) of discontinuation (reference was ACEi/indapamide FDC) in patients with ACEi/CCB FDCs (n=124,154) was 44,95% (HR=0.69, [CI: 0.68–0.69], p<0.0001), ARB/HCT FDCs (n=109,707) was 42,52% (HR=0.80, [CI: 0.81–0.83], p<0.0001), ACEi/indapamide FDC (n=127,757) was 37,27% (HR=1.00, reference), ARB/CCB FDCs (n=13,542) was 29.04% (HR=1.19, [CI: 1.17–1.22], p<0.0001) and ACEi/HCT FDCs (n=67,989) was 27.47% (HR=1.17, [CI: 1.15–1.18], p<0.0001). One year peristence of FDCs Conclusions We have found significant difference between FDC s of RAS-inhibitors in hypertensive in relation of patients adherence. Our result demonstrated that ACEi/CCBs FDC therapy has the best one year persistence rate.