고혈압 복합제 복용환자에서 동일계열약물 중복 현황

Abstract

Background: Fixed-dose combinations have the advantage of improving patient compliance, but may increase the risk of duplicateprescriptions. As the use of fixed-dose combination antihypertensives increases, it is necessary to investigate the current status ofclass duplication prescriptions (CDP) in patients taking fixed-dose combination antihypertensives in Korea and to identify factorsassociated with CDP. Methods: We conducted a retrospective observational study using nationally representative claim data. Hypertensive patients aged 20 years or older taking fixed-dose combination antihypertensives were extracted. Among these patients,patients with CDP were identified. A chi-square test was applied to determine the differences between patients with CDP and non-CDP. The associated factors of CDP were identified through multiple logistic regression. Results: Of the 74,165 patients who wereprescribed fixed-dose combination antihypertensives, 426 patients (0.6%) with CDP were identified. The most commonantihypertensive class associated with CDP was calcium channel blockers (194 patients, 45.5%), followed by angiotensin II receptorblockers (136 patients, 31.9%). Patients aged 75 years or older (odds ratio [OR] 1.83, 95% confidence interval [CI] 1.02-3.52),chronic kidney disease (OR 4.45, 95% CI 2.15-8.25), chronic heart failure (OR 2.71, 95% CI 1.93-3.72), coronary artery disease(OR 2.22, 95% CI 1.60-3.03) and Medical Aid/Patriots and Veterans Insurance (OR 1.49, 95% CI 1.04-2.07) were significantlyassociated with increased CDP. Conclusions: The factors associated with CDP were the elderly, comorbidities, and lowsocioeconomic status. Since CDP can result in negative clinical outcomes, active intervention by the pharmacist is warranted.