Implementing Single-Pill Combination Therapy for Hypertension: A Scoping Review of Key Health System Requirements in 30 Low- and Middle-Income Countries

Bruyn, E; Nguyen, L; Schutte, AE; Murphy, A; Perel, P; Webster, R

Implementing Single-Pill Combination Therapy for Hypertension: A Scoping Review of Key Health System Requirements in 30 Low- and Middle-Income Countries

Bruyn, E Nguyen, L Schutte, AE Murphy, A Perel, P Webster, R

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Publisher:: Ubiquity Press
Publication Type:: Journal Article
Citation:: Global Heart, 2022, 17, (1), pp. 6
Issue Date:: 2022-01-25

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Field	Value	Language
dc.contributor.author	Bruyn, E
dc.contributor.author	Nguyen, L
dc.contributor.author	Schutte, AE
dc.contributor.author	Murphy, A
dc.contributor.author	Perel, P
dc.contributor.author	Webster, R https://orcid.org/0000-0002-7444-3037
dc.date.accessioned	2023-05-25T01:52:12Z
dc.date.available	2021-12-03
dc.date.available	2023-05-25T01:52:12Z
dc.date.issued	2022-01-25
dc.identifier.citation	Global Heart, 2022, 17, (1), pp. 6
dc.identifier.issn	2211-8160
dc.identifier.issn	2211-8179
dc.identifier.uri	http://hdl.handle.net/10453/170443
dc.description.abstract	Objective: The World Health Organization (WHO) included single-pill combination (SPC) antihypertensive medications on their 2019 essential medicines list (EML) to encourage uptake and improved hypertension control. We documented key national-level facilitators (SPCs on national EMLs, recommendation for SPCs in national hypertension guidelines and availability of SPCs on the market) supporting uptake of SPCs in the 30 most populous low- and middle-income countries (LMICs).Methods: A hierarchical information gathering strategy was used including literature and web searches, the use of organisational databases and personal communications with colleagues to obtain information on (1) whether SPC antihypertensives are on national EMLs, (2) whether SPC antihypertensives are recommended in national hypertension guidelines and (3) whether SPCs are available on the market.Results: Eleven of 30 LMICs had all facilitators in place being Egypt, Kenya, Nigeria, Sudan, China, the Philippines, Thailand, Iran, Argentina, Colombia and Mexico. Twenty-six countries had national hypertension guidelines (or similar) in place with SPCs being recommended in 18 of these. Apart from Afghanistan, SPCs were available on the market in all countries. The facilitator least present was the inclusion of SPC antihypertensives on national EMLs at 12 of 29 (Turkey does not have an EML).Conclusion: This study demonstrated that many LMICs have made significant progress in their uptake of SPC antihypertensives and several had included SPCs on their EMLs and guidelines prior to their inclusion on the WHO EML. Despite this progress, the uptake of SPC antihypertensives in LMICs could be improved including through their further inclusion on EMLs.
dc.format	Electronic-eCollection
dc.language	eng
dc.publisher	Ubiquity Press
dc.relation.ispartof	Global Heart
dc.relation.isbasedon	10.5334/gh.1087
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1102 Cardiorespiratory Medicine and Haematology
dc.subject.mesh	Antihypertensive Agents
dc.subject.mesh	Developing Countries
dc.subject.mesh	Drug Combinations
dc.subject.mesh	Drugs, Essential
dc.subject.mesh	Humans
dc.subject.mesh	Hypertension
dc.subject.mesh	Humans
dc.subject.mesh	Hypertension
dc.subject.mesh	Antihypertensive Agents
dc.subject.mesh	Drug Combinations
dc.subject.mesh	Drugs, Essential
dc.subject.mesh	Developing Countries
dc.subject.mesh	Antihypertensive Agents
dc.subject.mesh	Developing Countries
dc.subject.mesh	Drug Combinations
dc.subject.mesh	Drugs, Essential
dc.subject.mesh	Humans
dc.subject.mesh	Hypertension
dc.title	Implementing Single-Pill Combination Therapy for Hypertension: A Scoping Review of Key Health System Requirements in 30 Low- and Middle-Income Countries
dc.type	Journal Article
utslib.citation.volume	17
utslib.location.activity	England
utslib.for	1102 Cardiorespiratory Medicine and Haematology
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Centre for Health Economics Research and Evaluation
utslib.copyright.status	open_access	*
dc.date.updated	2023-05-25T01:52:08Z
pubs.issue	1
pubs.publication-status	Published online
pubs.volume	17
utslib.citation.issue	1

Abstract:

Objective: The World Health Organization (WHO) included single-pill combination (SPC) antihypertensive medications on their 2019 essential medicines list (EML) to encourage uptake and improved hypertension control. We documented key national-level facilitators (SPCs on national EMLs, recommendation for SPCs in national hypertension guidelines and availability of SPCs on the market) supporting uptake of SPCs in the 30 most populous low- and middle-income countries (LMICs).Methods: A hierarchical information gathering strategy was used including literature and web searches, the use of organisational databases and personal communications with colleagues to obtain information on (1) whether SPC antihypertensives are on national EMLs, (2) whether SPC antihypertensives are recommended in national hypertension guidelines and (3) whether SPCs are available on the market.Results: Eleven of 30 LMICs had all facilitators in place being Egypt, Kenya, Nigeria, Sudan, China, the Philippines, Thailand, Iran, Argentina, Colombia and Mexico. Twenty-six countries had national hypertension guidelines (or similar) in place with SPCs being recommended in 18 of these. Apart from Afghanistan, SPCs were available on the market in all countries. The facilitator least present was the inclusion of SPC antihypertensives on national EMLs at 12 of 29 (Turkey does not have an EML).Conclusion: This study demonstrated that many LMICs have made significant progress in their uptake of SPC antihypertensives and several had included SPCs on their EMLs and guidelines prior to their inclusion on the WHO EML. Despite this progress, the uptake of SPC antihypertensives in LMICs could be improved including through their further inclusion on EMLs.

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http://hdl.handle.net/10453/170443