Optimization of adherence to fixed-dose combination therapy in the treatment of cardiovascular risk factors in primary care.

Objective: Provide consensus recommendations for the optimal management of fixed-dose combination therapies (FCT) in patients with cardiovascular risk factors (CVRF) in primary care (PC).

Material And Methods: A modified Delphi technique was used. A scientific committee wrote 80 statements addressing controversial issues regarding adherence and the use of FCT in patients with CVRF. A panel of 52 PC specialists, experts in CVRF management and adherence evaluated the questionnaire in two rounds. The work was promoted by the Network of Experts in Adherence in Primary Care (REAAP).

Results: Agreement was reached on 66 of the 80 issues (82.5%). The panellists considered that the adherence of patients with CVRF treated in PC was inadequate, which could have clinical implications. The use of FCT might increase adherence compared to separate treatments. FCT usage promotion in PC was considered necessary, especially in polymedicated patients. Measures such as establishing specific protocols or improving the training of professionals in the FTC use are necessary. The FTC use was recommended as a reduction in long-term cardiovascular events in hypertension was observed, together with changes of the concept of high-intensity statins to high-intensity lipid-lowering therapy in dyslipidemia, or considering the use of FCT if the option was available in type 2 diabetes mellitus.

Conclusions: The expert consensus recommendations from this work may facilitate the use of FCT in patients with CVRF in PC.