Narrative Review: The Influence of Single-Pill Combination (SPC) Antihypertensive Therapy on Medication Adherence in Patients with Hypertension
DOI:
https://doi.org/10.31941/benzena.v5i01.7982Keywords:
Hipertensi; Single Pill Combination; Kepatuhan Minum Obat; Persistensi Terapi; AntihipertensiAbstract
Background: Hypertension remains a chronic disease that requires long-term therapy; however, poor patient adherence to medication frequently limits treatment effectiveness. Single Pill Combination (SPC) was developed to simplify treatment by combining two or more antihypertensive agents into one tablet.
Objective: To analyze the effect of SPC antihypertensive therapy on medication adherence and its impact on clinical outcomes.
Method: This study used a narrative review approach through literature searches in PubMed, ScienceDirect, and Google Scholar. Articles published from 2010–2024 were selected based on predefined inclusion and exclusion criteria. And than 15 studies met the eligibility criteria and were included.
Results: The review demonstrated that SPC consistently improved medication adherence and treatment persistence compared with free-combination therapy. Adherence increased by approximately 20–30% among SPC users. SPC was also associated with better blood pressure control, reduced treatment discontinuation, and potential reductions in cardiovascular complications and healthcare costs.
Conclusion: SPC antihypertensive therapy is an effective strategy to improve medication adherence and optimize hypertension treatment outcomes. Further cost-effectiveness analysis studies are recommended to evaluate its economic value.
Keywords: Hypertension; Single Pill Combination; Medication Adherence; Antihypertensive; cost-effectiveness.
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References
Bangalore, S., Kamalakkannan, G., Parkar, S., & Messerli, F. H. (2007). Fixed-Dose Combinations Improve Medication Compliance : A Meta-Analysis. 713–719. https://doi.org/10.1016/j.amjmed.2006.08.033
Borghi, C., & Granados, D. (2023). Estimating the impact of single pill combination therapy for hypertension : projections of patient outcomes in Italy. 0. https://doi.org/10.2459/JCM.0000000000001494
Burnier, M., & Egan, B. M. (2019). Compendium on the Pathophysiology and Treatment of Hypertension Adherence in Hypertension. 1124–1140. https://doi.org/10.1161/CIRCRESAHA.118.313220
Coca, A., Whelton, S. P., Camafort, M., López-López, J. P., & Yang, E. (2024). Single-pill combination for treatment of hypertension: Just a matter of practicality or is there a real clinical benefit? Dalam European Journal of Internal Medicine (Vol. 126, hlm. 16–25). Elsevier B.V. https://doi.org/10.1016/j.ejim.2024.04.011
Dzudie, A., Barche, B., Zomene, F., Ebasone, P. V., Nkoke, C., Mouliom, S., Sidikatou, D., Lade, V., Ngote, H., Njankouo, Y. M., Mbatchou, B. H., Kamdem, F., Njebet, J., Kengne, A. P., & Choukem, S. P. (2023). Real-World Effectiveness and Safety of Two-Drug Single Pill Combinations of Antihypertensive Medications for Blood Pressure Management : A Follow-Up on Daily Cardiology Practice in Douala ,. Advances in Therapy, 40(5), 2282–2295. https://doi.org/10.1007/s12325-023-02461-w
Gianfranco Parati, Et. al. (2021). Adherence to Single-Pill Versus Free-Equivalent Combination Therapy in Hypertension. (February), 692–705. https://doi.org/10.1161/HYPERTENSIONAHA.120.15781
Gupta, A. K., Arshad, S., & Poulter, N. R. (2010). Antihypertensive Agents , Compliance Compliance , Safety , and Effectiveness of Fixed-Dose Combinations of Antihypertensive Agents. 59–61. https://doi.org/10.1161/HYPERTENSIONAHA.109.139816
Gupta, Et. al. (2010). Antihypertensive Agents , Compliance Compliance , Safety , and Effectiveness of Fixed-Dose Combinations of Antihypertensive Agents. 59–61. https://doi.org/10.1161/HYPERTENSIONAHA.109.139816
Hengky, A. (2023). Single Pill Combination sebagai Lini Pertama Terapi Hipertensi dan Proteksi Kardiovaskular.
Kim, S. J., Kwon, O. D., Cho, B., Oh, S., Lee, C. M., & Choi, H. (2019). Effects of combination drugs on antihypertensive medication adherence in a real-world setting : a Korean Nationwide Study. 1–10. https://doi.org/10.1136/bmjopen-2019-029862
Naser, N., Jatic, Z., & Avdic, S. (2022). The Effects of Single Pill Combinations on Adherence and Blood Pressure Control in Hypertensive Patients. 34(2), 130–135. https://doi.org/10.5455/msm.2022.34.130-135
Nguyen, L. H., Bruyn, E., Webster, R., Murphy, A., Perel, P., & Schutte, A. E. (2022). Are We There Yet? Exploring the Use of Single-Pill Combination Therapy in the Management of Raised Blood Pressure in Australia. Heart Lung and Circulation, 31(7), 954–963. https://doi.org/10.1016/j.hlc.2022.01.010
Sarzani, R., Laureti, G., Gezzi, A., Spannella, F., & Giulietti, F. (2022). Single-pill fixed-dose drug combinations to reduce blood pressure: the right pill for the right patient. Dalam Therapeutic Advances in Chronic Disease (Vol. 13). SAGE Publications Ltd. https://doi.org/10.1177/20406223221102754
Snyman, J. R., & Bortolotto, L. A. (2024). A real-world analysis of outcomes and healthcare costs of patients on perindopril/indapamide/ amlodipine single-pill vs. multiple-pill combination in Italy. 42(1), 136–142. https://doi.org/10.1097/HJH.0000000000003570
Tsioufis, K., Kreutz, R., Sykara, G., Van Vugt, J., & Hassan, T. (2020). Impact of single-pill combination therapy on adherence, blood pressure control, and clinical outcomes: A rapid evidence assessment of recent literature. Dalam Journal of Hypertension (Vol. 38, Nomor 6, hlm. 1016–1028). Lippincott Williams and Wilkins. https://doi.org/10.1097/HJH.0000000000002381
Weisser, B., Georg, H., Anton, P., Claudia, G., & Johannes, H. (2020). Single Pill Regimen Leads to Better Adherence and Clinical Outcome in Daily Practice in Patients Suffering from Hypertension and / or Dyslipidemia : Results of a Meta Analysis. High Blood Pressure & Cardiovascular Prevention, 27(2), 157–164. https://doi.org/10.1007/s40292-020-00370-5
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