{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T17:59:56Z","timestamp":1789235996034,"version":"build-2803163510"},"reference-count":37,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,5,24]]},"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We tried to clarify, by using representative national data in a real-world setting, whether single-pill combinations (SPCs) of antihypertensives actually improve medication adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A nationwide population-based study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>We used a 2.2% cohort (n=1 048 061) of the total population (n=46 605 433) that was randomly extracted by National Health Insurance of Korea from 2008 to 2013.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>We included patients (n=116\u2009677) who were prescribed with the same antihypertensive drugs for at least 1\u2009year and divided them into groups of angiotensin II receptor blocker (ARB)-only, calcium channel blocker (CCB)-only, multiple-pill combinations (MPCs) and SPCs of ARB\/CCB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measures<\/jats:title>\n                    <jats:p>Medication possession ratio (MPR), a frequently used indirect measurement method of medication adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Adjusted MPR was higher in combination therapy (89.7% in SPC, 87.2% in MPC) than monotherapy (81.6% in ARB, 79.7% in CCB), and MPR of SPC (89.7%, 95% CI 89.3 to 90.0) was higher than MPR of MPC (87.2%, 95% CI 86.7 to 87.7) (p&lt;0.05). In subgroup analysis, adherence of SPC and MPC was 92.3% (95% CI 91.5 to 93.0) vs 88.1% (95% CI 87.1 to 89.0) in those aged 65\u201374 years and 89.3% (95% CI 88.0 to 90.7) vs 84.8% (95% CI 83.3 to 92.0) in those \u226575 years (p&lt;0.05). According to total pill numbers, adherence of SPC and MPC was 90.9% (CI 89.8 to 92.0) vs 85.3% (95% CI 84.1 to 86.5) in seven to eight pills and 91.2% (95% CI 89.3 to 93.1) vs 82.5% (95% CI 80.6 to 84.4) in nine or more (p&lt;0.05). The adherence difference between SPC and MPC started to increase at five to six pills and at age 50\u201364 years (p&lt;0.05). When analysed according to elderly status, the adherence difference started to increase at three to four pills in the elderly (\u226565 years) and at five to six in the non-elderly group (20\u201364 years) (p&lt;0.05). These differences all widened further with increasing age and the total medications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SPC regimens demonstrated higher adherence than MPC, and this tendency is more pronounced with increasing age and the total number of medications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-029862","type":"journal-article","created":{"date-parts":[[2019,6,22]],"date-time":"2019-06-22T13:35:28Z","timestamp":1561210528000},"page":"e029862","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Effects of combination drugs on antihypertensive medication adherence in a real-world setting: a Korean Nationwide Study"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8885-7137","authenticated-orcid":false,"given":"Seung Jae","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Seoul St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oh Deog","family":"Kwon","sequence":"additional","affiliation":[{"name":"Navy Medical Office, ROK Submarine Force Command, Changwon, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BeLong","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Seoul National University Hospital, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung-Won","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheol Min","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho-Chun","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,6,22]]},"reference":[{"key":"2025121508353469000_9.6.e029862.1","unstructured":"Sabat\u00e9 E . 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