Adherence with single-pill amlodipine/atorvastatin vs a two-pill regimen
Bimal V Patel1, R Scott Leslie1, Patrick Thiebaud1, Michael B Nichol2, Simon SK Tang3, Henry Solomon3, Dennis Honda3, JoAnne M Foody41MedImpact Healthcare Systems, Inc., San Diego, CA, USA (Patrick Thiebaud was an employee of MedImpact Healthcare Systems, Inc. at the time the study was conducted; he...
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Format: | Article |
Language: | English |
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Dove Medical Press
2008-06-01
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Series: | Vascular Health and Risk Management |
Online Access: | https://www.dovepress.com/adherence-with-single-pill-amlodipineatorvastatin-vs-a-two-pill-regime-peer-reviewed-article-VHRM |
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author | Bimal V Patel R Scott Leslie Patrick Thiebaud Michael B Nichol Simon SK Tang et al |
author_facet | Bimal V Patel R Scott Leslie Patrick Thiebaud Michael B Nichol Simon SK Tang et al |
author_sort | Bimal V Patel |
collection | DOAJ |
description | Bimal V Patel1, R Scott Leslie1, Patrick Thiebaud1, Michael B Nichol2, Simon SK Tang3, Henry Solomon3, Dennis Honda3, JoAnne M Foody41MedImpact Healthcare Systems, Inc., San Diego, CA, USA (Patrick Thiebaud was an employee of MedImpact Healthcare Systems, Inc. at the time the study was conducted; he is currently employed by Pfizer Health Solutions); 2University of Southern California, Los Angeles, CA, USA; 3Pfizer Inc, New York, NY, USA; 4Yale University, New Haven, CT, USA (JoAnne Foody was affiliated with Yale University at the time the study was conducted; she is currently affiliated with Harvard Medical School, Boston, MA, USA)Abstract: While clinical trials demonstrate the benefits of blood pressure and cholesterol reduction, medication adherence in clinical practice is problematic. We hypothesized that a single-pill would be superior to a 2-pill regimen for achieving adherence. In this retrospective, cohort study based on pharmacy claims data, patients newly initiated on a calcium channel blocker (CCB) or statin simultaneously or within 30 days, regardless of sequence, were followed (N = 4703). Adherence was measured over 6 months as proportion of days covered (PDC). At baseline, mean age was 63.0 years, 51.6% were female, and mean number of other medications was 7.8. Overall, 16.9% of patients were on single-pill amlodipine/atorvastatin, 15.6% amlodipine + atorvastatin, 24.7% amlodipine + other statin, 13.9% other CCB + atorvastatin, 28.9% other CCB + other statin. Percentages of patients achieving adherence (PDC ≥ 80%) were: 67.7% amlodipine/atorva statin; 49.9% amlodipine + atorvastatin; 40.4% amlodipine + other statin; 46.9% other CCB + atorvastatin; 37.4% other CCB + other statin. After adjusting for treatment selection and cohort differences, odds ratios for adherence with amlodipine/atorvastatin were 1.95 (95% confidence interval [CI], 1.80–2.13) vs amlodipine + atorvastatin, 3.10 (95% CI, 2.85–3.38) vs amlodipine + other statin, 2.06 (95% CI, 1.89–2.24) vs other CCB + atorvastatin, 2.85 (95% CI, 2.61–3.10) vs other CCB + other statin (all p < 0.0001). Single-pill amlodipine/atorvastatin may provide clinical benefits through improving adherence, offering clinicians a practical solution for cardiovascular risk management.Keywords: amlodipine besylate, atorvastatin calcium, adherence, persistence |
first_indexed | 2024-12-10T15:54:53Z |
format | Article |
id | doaj.art-c926d3d28a6b413a9cc6c2addb12ad2b |
institution | Directory Open Access Journal |
issn | 1178-2048 |
language | English |
last_indexed | 2024-12-10T15:54:53Z |
publishDate | 2008-06-01 |
publisher | Dove Medical Press |
record_format | Article |
series | Vascular Health and Risk Management |
spelling | doaj.art-c926d3d28a6b413a9cc6c2addb12ad2b2022-12-22T01:42:42ZengDove Medical PressVascular Health and Risk Management1178-20482008-06-01Volume 46736811912Adherence with single-pill amlodipine/atorvastatin vs a two-pill regimenBimal V PatelR Scott LesliePatrick ThiebaudMichael B NicholSimon SK Tanget alBimal V Patel1, R Scott Leslie1, Patrick Thiebaud1, Michael B Nichol2, Simon SK Tang3, Henry Solomon3, Dennis Honda3, JoAnne M Foody41MedImpact Healthcare Systems, Inc., San Diego, CA, USA (Patrick Thiebaud was an employee of MedImpact Healthcare Systems, Inc. at the time the study was conducted; he is currently employed by Pfizer Health Solutions); 2University of Southern California, Los Angeles, CA, USA; 3Pfizer Inc, New York, NY, USA; 4Yale University, New Haven, CT, USA (JoAnne Foody was affiliated with Yale University at the time the study was conducted; she is currently affiliated with Harvard Medical School, Boston, MA, USA)Abstract: While clinical trials demonstrate the benefits of blood pressure and cholesterol reduction, medication adherence in clinical practice is problematic. We hypothesized that a single-pill would be superior to a 2-pill regimen for achieving adherence. In this retrospective, cohort study based on pharmacy claims data, patients newly initiated on a calcium channel blocker (CCB) or statin simultaneously or within 30 days, regardless of sequence, were followed (N = 4703). Adherence was measured over 6 months as proportion of days covered (PDC). At baseline, mean age was 63.0 years, 51.6% were female, and mean number of other medications was 7.8. Overall, 16.9% of patients were on single-pill amlodipine/atorvastatin, 15.6% amlodipine + atorvastatin, 24.7% amlodipine + other statin, 13.9% other CCB + atorvastatin, 28.9% other CCB + other statin. Percentages of patients achieving adherence (PDC ≥ 80%) were: 67.7% amlodipine/atorva statin; 49.9% amlodipine + atorvastatin; 40.4% amlodipine + other statin; 46.9% other CCB + atorvastatin; 37.4% other CCB + other statin. After adjusting for treatment selection and cohort differences, odds ratios for adherence with amlodipine/atorvastatin were 1.95 (95% confidence interval [CI], 1.80–2.13) vs amlodipine + atorvastatin, 3.10 (95% CI, 2.85–3.38) vs amlodipine + other statin, 2.06 (95% CI, 1.89–2.24) vs other CCB + atorvastatin, 2.85 (95% CI, 2.61–3.10) vs other CCB + other statin (all p < 0.0001). Single-pill amlodipine/atorvastatin may provide clinical benefits through improving adherence, offering clinicians a practical solution for cardiovascular risk management.Keywords: amlodipine besylate, atorvastatin calcium, adherence, persistencehttps://www.dovepress.com/adherence-with-single-pill-amlodipineatorvastatin-vs-a-two-pill-regime-peer-reviewed-article-VHRM |
spellingShingle | Bimal V Patel R Scott Leslie Patrick Thiebaud Michael B Nichol Simon SK Tang et al Adherence with single-pill amlodipine/atorvastatin vs a two-pill regimen Vascular Health and Risk Management |
title | Adherence with single-pill amlodipine/atorvastatin vs a two-pill regimen |
title_full | Adherence with single-pill amlodipine/atorvastatin vs a two-pill regimen |
title_fullStr | Adherence with single-pill amlodipine/atorvastatin vs a two-pill regimen |
title_full_unstemmed | Adherence with single-pill amlodipine/atorvastatin vs a two-pill regimen |
title_short | Adherence with single-pill amlodipine/atorvastatin vs a two-pill regimen |
title_sort | adherence with single pill amlodipine atorvastatin vs a two pill regimen |
url | https://www.dovepress.com/adherence-with-single-pill-amlodipineatorvastatin-vs-a-two-pill-regime-peer-reviewed-article-VHRM |
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