REAL-WORLD ANALYSIS OF ADHERENCE, PERSISTENCE AND OUTCOMES IN PATIENTS RECEIVING QUADRUPLE THERAPY WITH PERINDOPRIL, INDAPAMIDE, AMLODIPINE AND BISOPROLOL IN ITALY

作者：G Mancia, Sofie Brouwers, Silvia Calabria, Melania Leogrande, Degli Esposti L, Giovambattista Desideri, Krzysztof Narkiewicz · 发表于：Journal of Hypertension · 年份：2026 · DOI：10.1097/01.hjh.0001197508.67017.69 · 研究领域：Medication Adherence and Compliance、Pharmaceutical Practices and Patient Outcomes、Pharmacovigilance and Adverse Drug Reactions

Objective: To assess the effects of pill burden on adherence, persistence, non-fatal cardiovascular (CV) events and all-cause mortality in adult patients treated with the combination of perindopril (PER), indapamide (IND), amlodipine (AML) and bisoprolol (BIS). Design and method: This was an observational, retrospective, longitudinal cohort study of administrative healthcare databases based on the Italian National Healthcare Service. Eligible patients were at least 18 years old and received PER+IND+AML+BIS with data available at least 1 year before and 1 year after quadruple therapy identification. Primary endpoints were adherence to the four drugs (calculated as proportion of days covered by prescription [PDC], assessed as low [<40%], moderate [40–79%] or high [>=80%]) and persistence (presence of dispensation of the four drugs in last trimester) at 6, 9 and 12 months, stratified by number of pills. Secondary endpoints included non-fatal CV events and all-cause mortality. Cox's proportional hazards model was applied to estimate hazard ratios (HRs) adjusting for baseline covariates, including demographics, comorbidities and previous treatments. Results: Overall, 8007 patients (mean age 68.9±11.5 years, 52.5% male) received PER+IND+AML+BIS; 2489 (31.1%) had diabetes and 1279 (16.0%) ischaemic heart disease. Most patients received PER+IND+AML+BIS as two pills (Table). Adherence and persistence at all timepoints were significantly higher for patients receiving two pills versus t...