{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T14:17:21Z","timestamp":1783693041220,"version":"3.55.0"},"reference-count":66,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Hypertension"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Background<\/jats:bold>\n                    : Uncontrolled hypertension is a leading driver of heart disease, chronic kidney disease, heart failure, dementia, stroke, and pregnancy\u2010related complications. Fixed\u2010dose combinations (FDCs) are guideline\u2010endorsed first\u2010line therapies that improve blood pressure control by reducing pill burden, improving adherence, and targeting multiple pathophysiological mechanisms. However, FDC utilization remains low across U.S. health systems. Few studies examine the factors influencing FDC uptake; existing qualitative studies rarely interrogate structural barriers or formulate stakeholder\u2010informed recommendations.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods<\/jats:bold>\n                    : We explored the perspectives of providers, population health stakeholders, and health system executives through semi\u2010structured interviews\/thematic analysis to identify structural and provider\u2010level barriers to FDC utilization and formulate recommendations for health systems.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results<\/jats:bold>\n                    : Structural barriers included low exposure to FDCs early in training, entrenched monotherapy\u2010reliant cultures, workflow constraints, fragmented formularies, and absent performance incentives and leadership endorsements. Provider\u2010level perspectives and practices diverged: clinicians reported minimal use of FDCs, limited familiarity with FDCs, and concerns about dosage inflexibility and adverse effects. By contrast, pharmacists and nurse practitioners identified as major proponents of FDCs, demonstrated broad familiarity with therapeutic and cost advantages, and reframed clinicians concerns as misconceptions due to limited exposure.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions<\/jats:bold>\n                    : To improve FDC utilization, we propose: (1) integrating FDC exposure into early medical and pharmacy curricula; (2) embedding decision\u2010support tools and SmartSets that prompt FDC consideration into electronic medical records; (3) expanding team\u2010based care models to distribute responsibility for medication intensification; (4) securing leadership endorsements, novel incentive structures for providers, and data tracking mechanisms; and (5) fostering normative change through champions, CME\u2010accredited workshops, and socialization strategies.\n                  <\/jats:p>","DOI":"10.1111\/jch.70300","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T09:17:52Z","timestamp":1780391872000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fixed\u2010Dose Combinations for Hypertension: Barriers to Use and Opportunities for Health Systems"],"prefix":"10.1111","volume":"28","author":[{"given":"Pranay","family":"Narang","sequence":"first","affiliation":[{"name":"University of California, Berkeley, University of California, San Francisco Joint Medical Program  Berkeley California USA"},{"name":"Philip R. 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(2025).High Blood Pressure Facts. High Blood Pressure https:\/\/www.cdc.gov\/high\u2010blood\u2010pressure\/data\u2010research\/facts\u2010stats\/index.html."},{"key":"e_1_2_9_4_1","unstructured":"Cleveland Clinic. (2023).High Blood Pressure: What You Need to Know https:\/\/my.clevelandclinic.org\/health\/diseases\/4314\u2010hypertension\u2010high\u2010blood\u2010pressure."},{"key":"e_1_2_9_5_1","unstructured":"WHO. (2025).Hypertension. Retrieved July 15 2025 fromhttps:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/hypertension."},{"key":"e_1_2_9_6_1","unstructured":"CDC. (2024).Estimated Hypertension Prevalence Treatment and Control Among U.S. Adults. Centers for Disease Control and Prevention https:\/\/millionhearts.hhs.gov\/data\u2010reports\/hypertension\u2010prevalence.html."},{"key":"e_1_2_9_7_1","unstructured":"CDC. 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