摘要
目的 系统评价单片复方制剂(SPC)与自由联合用药(FEC)治疗高血压患者的依从性。方法 计算机检索PubMed、Embase、Cochrane Library、Web of Science、CBM、WanFang Data和CNKI数据库,搜集与研究目的相关的队列研究和随机对照试验(RCT),检索时限均从建库至2025年3月。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用R 4.3.3软件进行Meta分析。结果 共纳入21个研究,含4个RCT和17个队列研究,包含461 030例患者。Meta分析结果显示:SPC在高血压用药天数占比[OR=2.53,95%CI(1.67,3.82),P<0.01]和药物持有率[OR=2.05,95%CI(1.23,3.42),P=0.02]方面,患者依从性均高于FEC,差异有统计学意义。但SPC与FEC在收缩压、舒张压的血压降幅上差异无统计学意义(P>0.05)。结论 现有证据表明,SPC可提高高血压患者用药依从性。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。
Objective To systematically review the medication adherence of patients with hypertension treated with single-pill combinations(SPC)compared with free combination therapy(FEC).Methods The PubMed,Embase,Cochrane Library,Web of Science,CBM,WanFang Data,and CNKI databases were electronically searched to collect cohort studies and randomized controlled trials(RCTs)related to the objectives from inception to March 2025.Two reviewers independently screened literature,extracted data and assessed the risk of bias of the included studies.Metaanalysis was then performed by using R 4.3.3 software.Results A total of 21 studies were included,comprising 4 RCTs and 17 cohort studies,involving 461030 patients.Meta-analysis showed that SPC therapy significantly improved medication adherence compared with FEC in terms of proportion of days covered(PDC)(OR=2.53,95%CI 1.67 to 3.82,P<0.01)and medication possession ratio(MPR)(OR=2.05,95%CI 1.23 to 3.42,P=0.02),with statistically significant differences.However,there was no statistically significant difference in blood pressure reduction between SPC and FEC for both systolic blood pressure(SBP)and diastolic blood pressure(DBP)(P>0.05).Conclusion Current evidence shows that SPC can improve medication adherence in patients with hypertension.Due to the limited quality and quantity of the included studies,more high quality studies are needed to verify the above conclusion.
作者
王耀羚
杨畅
李睿
高鑫
肖非易
张晓路
王培蒙
李雪
郭武栋
WANG Yaoling;YANG Chang;LI Rui;GAO Xin;XIAO Feiyi;ZHANG Xiaolu;WANG Peimeng;LI Xue;GUO Wudong(Department of Health Technology Assessment,China National Development Research Center,Beijing 100044,P.R.China;School of Public Health,Dalian Medical University,Dalian 116044,P.R.China)
出处
《中国循证医学杂志》
北大核心
2025年第11期1311-1317,共7页
Chinese Journal of Evidence-based Medicine
基金
国家卫生健康委卫生发展研究中心科研项目(编号:20231504369)。
关键词
单片复方制剂
高血压
系统评价
META分析
依从性
Single-pill combinations(SPC)
Hypertension
Systematic review
Meta-analysis
Adherence
