The Effectiveness of Single-Pill Combination (SPC) Compared to Free-Combination Therapy in Improving Long-Term Treatment Adherence in Hypertensive Patients: A Systematic Review
DOI:
https://doi.org/10.31004/joecy.v6i1.8966Keywords:
Hypertension, Treatment Adherence, Single-Pill Combination, Free Combination, Pill Burden.Abstract
Background: Hypertension remains a global health crisis with suboptimal blood pressure control due to poor long-term treatment adherence, exacerbated by high pill burden in free-combination therapies. Objective: This systematic review evaluates the effectiveness of Single-Pill Combination (SPC) versus Free-Combination (FC) in improving adherence among hypertensive patients. Methods: Following PRISMA 2020 guidelines, we searched PubMed, Semantic Scholar, and Google Scholar (2015-2025) for RCTs and cohort studies using PICOS framework. Nine studies (3 RCTs, 6 cohorts; N>270,000 patients) were assessed via RoB 2.0 and ROBINS-I tools, with narrative synthesis. Population/Sample: Adult essential hypertension patients receiving combination antihypertensives. Instruments/Data Analysis: Risk of bias tools and structured data extraction for adherence metrics (PDC, MPR, persistence). Results: Eight studies showed SPC superiority (higher PDC/MPR, OR up to 3.63), linked to better BP control. Conclusion: SPC should be prioritized clinically to enhance adherence and outcomes, despite methodological heterogeneity.
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