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van der Laan DM, Elders PJM, Boons CCLM, Bosmans JE, Nijpels G, Hugtenburg JG. The (cost-)effectiveness of a patient-tailored intervention programme to enhance adherence to antihypertensive medication in community pharmacies: study protocol of a randomised controlled trial. Trials 2017; 18:29. [PMID: 28103948 PMCID: PMC5244518 DOI: 10.1186/s13063-016-1696-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 11/10/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Medication non-adherence is a complex health care problem. Due to non-adherence, substantial numbers of cardiovascular patients benefit from their medication to only a limited extent. In order to improve adherence, a variety of pharmacist-led interventions have been developed. However, even the most effective interventions achieved only a modest positive effect. To be effective, interventions should be targeted at underlying barriers to adherence, developed in a systematic manner and tailored to specific features of a target group and setting. The current paper describes the design of the Cardiovascular medication non-Adherence Tailored Intervention (CATI) study aimed to evaluate the (cost-)effectiveness of a patient-tailored intervention programme in patients using antihypertensive medication. METHODS The CATI study is a randomised controlled trial that will be performed in 13 community pharmacies. Patients aged 45-75 years using antihypertensive medication and considered non-adherent according to pharmacy dispensing data, as well according to a self-report questionnaire, are eligible to participate. Patients in the intervention condition will receive a patient-tailored, pharmacist-led intervention programme. This programme consists of a structured interview at the pharmacy to identify patients' barriers to adherence and to counsel patients in order to overcome these barriers. The primary outcome is self-reported medication adherence measured with the MARS-5 questionnaire. Secondary outcome measures are blood pressure, illness perceptions, quality of life and societal costs. A cost-effectiveness analysis and process evaluation will also be performed. DISCUSSION This study will provide insight into the (cost-)effectiveness of a patient-tailored, pharmacist-led intervention programme in non-adherent patients using antihypertensive medication. This intervention programme allows community pharmacists to support their patients in overcoming barriers to adherence and improving medication adherence in a structured and patient-tailored manner. An effective intervention will not only enhance medication adherence, but may also improve health outcomes and decrease health care utilisation and costs. TRIAL REGISTRATION Netherlands Trial Register (identifier: NTR5017), registered on 2 February 2015.
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Affiliation(s)
- Danielle M van der Laan
- Department of Clinical Pharmacology and Pharmacy and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
| | - Petra J M Elders
- Department of General Practice and Elderly Care Medicine and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Christel C L M Boons
- Department of Clinical Pharmacology and Pharmacy, VU University Medical Center, Amsterdam, The Netherlands
| | - Judith E Bosmans
- Department of Health Sciences and the Amsterdam Public Health Research Institute, Faculty of Earth and Life Sciences, VU University, Amsterdam, The Netherlands
| | - Giel Nijpels
- Department of General Practice and Elderly Care Medicine and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Jacqueline G Hugtenburg
- Department of Clinical Pharmacology and Pharmacy and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
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102
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Rhee MY, Ahn T, Chang K, Chae SC, Yang TH, Shim WJ, Kang TS, Ryu JK, Nah DY, Park TH, Chae IH, Park SW, Lee HY, Tahk SJ, Yoon YW, Shim CY, Shin DG, Seo HS, Lee SY, Kim DI, Kwan J, Joo SJ, Jeong MH, Jeong JO, Sung KC, Kim SY, Kim SH, Chun KJ, Oh DJ. The efficacy and safety of co-administration of fimasartan and rosuvastatin to patients with hypertension and dyslipidemia. BMC Pharmacol Toxicol 2017; 18:2. [PMID: 28057081 PMCID: PMC5217661 DOI: 10.1186/s40360-016-0112-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 12/13/2016] [Indexed: 12/15/2022] Open
Abstract
Background Hypertension and dyslipidemia are major risk factors of cardiovascular disease (CVD) events. The objective of this study was to evaluate the efficacy and safety of the co-administration of fimasartan and rosuvastatin in patients with hypertension and hypercholesterolemia. Methods We conducted a randomized double-blind and parallel-group trial. Patients who met eligible criteria after 4 weeks of therapeutic life change were randomly assigned to the following groups. 1) co-administration of fimasartan 120 mg/rosuvastatin 20 mg (FMS/RSV), 2) fimasartan 120 mg (FMS) alone 3) rosuvastatin 20 mg (RSV) alone. Drugs were administered once daily for 8 weeks. Results Of 140 randomized patients, 135 for whom efficacy data were available were analyzed. After 8 weeks of treatment, the FMS/RSV treatment group showed greater reductions in sitting systolic (siSBP) and diastolic (siDBP) blood pressures than those in the group receiving RSV alone (both p < 0.001). Reductions in siSBP and siDBP were not significantly different between the FMS/RSV and FMS alone groups (p = 0.500 and p = 0.734, respectively). After 8 weeks of treatment, FMS/RSV treatment showed greater efficacy in percentage reduction of low-density lipoprotein cholesterol (LDL-C) level from baseline than that shown by FMS alone treatment (p < 0.001). The response rates of siSBP with FMS/RSV, FMS alone, and RSV alone treatments were 65.22, 55.56, and 34.09%, respectively (FMS/RSV vs. RSV, p = 0.006). The LDL-C goal attainment rates with FMS/RSV, RSV alone, and FMS alone treatments were 80.43%, 81.82%, and 15.56%, respectively (FMS/RSV vs. FMS, p < 0.001). Incidence of adverse drug reactions with FMS/RSV treatment was 8.33%, which was similar to those associated with FMS and RSV alone treatments. Conclusion This study demonstrated that the co-administration of fimasartan and rosuvastatin to patients with both hypertension and hypercholesterolemia was efficacious and safe. Trial registration ClinicalTrials.gov Identifier: NCT02166814. 16 June 2014 Electronic supplementary material The online version of this article (doi:10.1186/s40360-016-0112-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Moo-Yong Rhee
- Cardiovascular Center, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Taehoon Ahn
- Division of Cardiology, Gachon University Gil Hospital, Incheon, Republic of Korea
| | - Kiyuk Chang
- Division of Cardiology, Seoul St. Mary's Hospital, Seoul, Republic of Korea
| | - Shung Chull Chae
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Tae-Hyun Yang
- Division of Cardiology, Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - Wan Joo Shim
- Division of Cardiology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Tae Soo Kang
- Department of Cardiology, Dankook University Hospital, Cheonan, Republic of Korea
| | - Jae-Kean Ryu
- Department of Internal Medicine, Daegu Catholic University Hospital, Daegu, Republic of Korea
| | - Deuk-Young Nah
- Division of Cardiology, Dongguk University Gyeongju Hospital, Gyeongju, Republic of Korea
| | - Tae-Ho Park
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Republic of Korea
| | - In-Ho Chae
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Seung Woo Park
- Division of Cardiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hae-Young Lee
- Division of Cardiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seung-Jea Tahk
- Department of Cardiology, Ajou University Hospital, Suwon, Republic of Korea
| | - Young Won Yoon
- Division of Cardiology, Gangnam Severance Hospital, Seoul, Republic of Korea
| | - Chi Young Shim
- Division of Cardiology, Severance Cardiovascular Hospital, Seoul, Republic of Korea
| | - Dong-Gu Shin
- Department of Cardiology, Yeungnam University Hospital, Daegu, Republic of Korea
| | - Hong Seog Seo
- Division of Cardiology, Korea University Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Sung Yun Lee
- Cardiac and Vascular Center, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Doo Il Kim
- Department of Cardiology, Inje University Haeundae Paik Hospital, Busan, Republic of Korea
| | - Jun Kwan
- Department of Cardiology, Inha University Hospital, Incheon, Republic of Korea
| | - Seung-Jae Joo
- Division of Cardiology, Jeju National University Hospital, Jeju, Republic of Korea
| | - Myung Ho Jeong
- Department of Cardiovascular, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Jin-Ok Jeong
- Division of Cardiology, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Ki Chul Sung
- Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seok Yeon Kim
- Department of Cardiology, Seoul Medical Center, Seoul, Republic of Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Seoul Metropolitan Government Seoul National University Hospital Boramae Medical Center, Seoul, Republic of Korea
| | - Kook-Jin Chun
- Cardiovascular Center, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Dong Joo Oh
- Division of Cardiology, Korea University Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea.
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Fujiwara N, Tanaka A, Kawaguchi A, Tago M, Oyama JI, Uchida Y, Matsunaga K, Moroe K, Toyoda S, Inoue T, Ikeda H, Node K. Association Between Blood Pressure Lowering and Quality of Life by Treatment of Azilsartan. Int Heart J 2017; 58:752-761. [DOI: 10.1536/ihj.16-511] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
| | | | | | - Motoko Tago
- Department of Cardiovascular Medicine, Saga University
| | | | | | | | - Kazuo Moroe
- Department of Cardiovascular Medicine, Moroe Cardiovascular Clinic
| | - Shigeru Toyoda
- Department of Cardiovascular Medicine, Dokkyo Medical University
| | - Teruo Inoue
- Department of Cardiovascular Medicine, Dokkyo Medical University
| | - Hideo Ikeda
- Department of Internal Medicine, Ikeda Naika Hifuka Clinic
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
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