Does a Combination Pill of Antihypertensive Drugs Improve Medication Adherence in Japanese? – A Randomized Controlled Trial –

Kiyoshi Matsumura; Hisatomi Arima; Mitsuhiro Tominaga; Toshio Ohtsubo; Toshiyuki Sasaguri; Koji Fujii; Masayo Fukuhara; Keiko Uezono; Yuki Morinaga; Yuko Ohta; Takatoshi Otonari; Junya Kawasaki; Isao Kato; Takuya Tsuchihashi; for the COMFORT Investigators

doi:10.1253/circj.CJ-11-1481

Hypertension and Circulatory Control

Does a Combination Pill of Antihypertensive Drugs Improve Medication Adherence in Japanese?

– A Randomized Controlled Trial –

Kiyoshi Matsumura, Hisatomi Arima, Mitsuhiro Tominaga, Toshio Ohtsubo, Toshiyuki Sasaguri, Koji Fujii, Masayo Fukuhara, Keiko Uezono, Yuki Morinaga, Yuko Ohta, Takatoshi Otonari, Junya Kawasaki, Isao Kato, Takuya Tsuchihashi, for the COMFORT Investigators

Author information

Kiyoshi Matsumura
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
Hisatomi Arima
The George Institute for Global Health, University of Sydney
Mitsuhiro Tominaga
Division of Cardiology, Kyushu Central Hospital
Toshio Ohtsubo
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
Toshiyuki Sasaguri
Department of Clinical Pharmacology, Kyushu University
Koji Fujii
Division of Internal Medicine, Imazu Red Cross Hospital
Masayo Fukuhara
Department of Environmental Medicine, Kyushu University
Keiko Uezono
Institute of Health Science, Kyushu University
Yuki Morinaga
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
Yuko Ohta
Division of Hypertension, National Kyushu Medical Center
Takatoshi Otonari
Otonari Clinic
Junya Kawasaki
Kawasaki Cardiovascular Clinic
Isao Kato
Kato Clinic
Takuya Tsuchihashi
Division of Hypertension, National Kyushu Medical Center
for the COMFORT Investigators

Keywords: Adherence, Combination pill, Hypertension, Randomized controlled trial

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Supplementary material

2012 Volume 76 Issue 6 Pages 1415-1422

DOI https://doi.org/10.1253/circj.CJ-11-1481

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Abstract

Background: In order to achieve target blood pressure levels to prevent cardiovascular disease, combination therapy of antihypertensive drugs is often required, although it is thought that requiring a patient to take many different pills would reduce adherence to the medication regimen. Whether antihypertensive treatment with a single pill combining antihypertensive drugs would improve medication adherence and blood pressure control was investigated. Methods and Results: A total of 207 hypertensive subjects were randomly assigned to a combination pill group (losartan 50mg/hydrochlorothiazide 12.5mg; n=103) or a control group (an angiotensin receptor blocker and a thiazide diuretic; n=104). Medication adherence was evaluated by pill counts at 1, 3, and 6 months after randomization. The mean adherence rates over 6 months were not different between the 2 groups: 98% in the combination pill group and 98% in the control group. Moreover, the 2 groups included similar numbers of subjects with relatively poor adherence rates (<90%) in each treatment period. The mean blood pressures over the 6-month treatment period were not different between the groups: 131/75mmHg in the combination pill group and 130/75mmHg in the control group (P=0.84/0.96). Conclusions: There were no appreciable effects of the combination pill of antihypertensive drugs on medication adherence or blood pressure control in Japanese patients over a 6-month period. (Circ J 2012; 76: 1415-1422)

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