Who benefits from fixed-dose combinations? Two-year statin adherence trajectories in initiators of combined amlodipine/atorvastatin therapy.
Pharmacoepidemiol Drug Saf
; 26(12): 1465-1473, 2017 Dec.
Article
em En
| MEDLINE
| ID: mdl-29067759
ABSTRACT
PURPOSE:
We compared statin adherence in individuals initiating combined amlodipine/atorvastatin therapy as a fixed-dose (FDC) or free combination and identified subgroups benefiting most from FDCs.METHODS:
We used a 10% sample of Australian Pharmaceutical Benefits Scheme dispensing data (2005-2015) to identify individuals initiating amlodipine and atorvastatin as an FDC (n = 3996) or free combination (n = 5434), with or without prior statin dispensing. We measured the proportion of days covered in each 30-day period over 24 months and classified patterns of statin adherence using group-based trajectory models. We identified predictors of adherence trajectories using logistic regression.RESULTS:
The median age was 71 years, and 53% were female. We identified 4 patterns of statin adherence near-perfect adherence (n = 5383), good adherence (n = 1893), declining adherence (n = 1247), and early nonadherence (n = 907). Compared with the free combination, FDC initiators were more likely to have near-perfect adherence if they were previously statin adherent irrespective of amlodipine dose (amlodipine 5 mg OR = 1.61, 95% CI 1.38-1.87; amlodipine 10 mg OR = 2.39, 95% CI 1.63-3.51) or they were previously statin nonadherent and initiated on the 5 mg amlodipine dose (OR = 1.87, 95% CI 1.50-2.32). Statin-naïve individuals initiating on the FDC with 10 mg amlodipine were less likely to have near-perfect adherence (OR = 0.60, 95% CI 0.41-0.88) and more likely to have early nonadherence (OR = 1.73, 95% CI 1.17-2.55).CONCLUSIONS:
The amlodipine/atorvastatin FDC was associated with greater statin adherence among prevalent statin users, and individuals who initiated on lower amlodipine doses. The FDCs did not improve adherence in statin-naïve individuals and in some cases resulted in poorer adherence.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Pirróis
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Anlodipino
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Adesão à Medicação
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Ácidos Heptanoicos
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Anticolesterolemiantes
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Anti-Hipertensivos
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article