Dataset Information

Impact of once-daily versus twice-daily dosing frequency on adherence to chronic medications among patients with venous thromboembolism.

ABSTRACT:

Background

Multiple daily dosing may be negatively associated with patient medication adherence; however, adherence-related data are lacking in a patient population with venous thromboembolism (VTE).

Objective

To assess the adherence rates between once-daily (OD) and twice-daily (BID) dosing regimens of chronic medications in patients with VTE.

Methods

We analyzed the PharMetrics Integrated Claims database (claims of commercial insurers in the US) from 1 January 2004, through 31 December 2009. Adult patients with continuous insurance coverage, newly initiated on diabetes mellitus or hypertension medication, and having at least one VTE diagnosis were included. Adherence to OD and BID therapies was calculated by using two measures: medication possession ratio (MPR) and proportion of days covered (PDC). Adherence was defined as an MPR or PDC ?0.8. Multivariate logistic regressions were conducted to compare the probability of adherence between the OD and BID groups adjusting for baseline confounders.

Results

A total of 4,867 OD and 1,069 BID patients were identified. Mean duration of exposure to therapy for OD and BID patients was 386 and 356 days (p = 0.011), respectively. Based on MPR, 69 % of OD and 62 % of BID patients were adherent (p < 0.001). For PDC at 12 months, the proportion of adherent patients for the OD and BID groups was 45 and 36 % (p < 0.001), respectively. Adjusted odds ratios (95 % CI) of adherence for the OD relative to BID group were 1.61 (1.37-1.89) based on MPR (p < 0.001) and 1.46 (1.16-1.83) based on PDC at 12 months (p = 0.001).

Conclusions

This study demonstrates that VTE patients treated with chronic medications on OD dosing regimens were associated with an approximately 39-61 % higher likelihood of adherence compared with subjects on BID dosing regimens.

SUBMITTER: Laliberte F

PROVIDER: S-EPMC3751276 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Publications

Impact of once-daily versus twice-daily dosing frequency on adherence to chronic medications among patients with venous thromboembolism.

Laliberté François F Bookhart Brahim K BK Nelson Winnie W WW Lefebvre Patrick P Schein Jeff R JR Rondeau-Leclaire Jonathan J Duh Mei Sheng MS

The patient 20130101 3

<h4>Background</h4>Multiple daily dosing may be negatively associated with patient medication adherence; however, adherence-related data are lacking in a patient population with venous thromboembolism (VTE).<h4>Objective</h4>To assess the adherence rates between once-daily (OD) and twice-daily (BID) dosing regimens of chronic medications in patients with VTE.<h4>Methods</h4>We analyzed the PharMetrics Integrated Claims database (claims of commercial insurers in the US) from 1 January 2004, throu ...[more]

PMID: 23857628

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Project description:BackgroundPrevalence of immunosuppressant nonadherence in renal transplant recipients is high despite negative clinical outcomes associated with nonadherence. Simplification of dosing has been demonstrated to improve adherence in renal transplant recipients as measured through electronic monitoring and self-report.ObjectiveThe purpose of this study was to replicate and extend previous findings by measuring adherence with multiple methods in a Canadian sample.DesignThe study design was a randomized controlled medication dosing trial in adult renal transplant patients. The trial length was 4 months.SettingThis study was conducted within the Solid Organ Transplant (SOT) Clinic at Vancouver General Hospital (VGH; Vancouver, Canada).PatientsA total of 46 adult renal recipients (at least 1 year post-transplant) were recruited through the SOT clinic. With 8 withdrawals, 38 individuals completed all phases of the study.MeasurementsMedication adherence was measured for a period of 4 months using multiple methods, including electronic monitoring (MEMS [Medication Event Monitoring System]), pharmacy refill data (medication possession ratio [MPR]), and by self-report using the Adherence subscale of the Transplant Effects Questionnaire (TEQ).MethodsParticipants were randomized to twice-daily (n = 19) or once-daily tacrolimus dosing (n = 19) and followed over a 4-month period via monthly clinic study visits. Comparisons between the treatment groups were performed using the Mann-Whitney U and chi-square tests, for continuous and categorical variables, respectively.ResultsAs outlined in Table 3, the once-daily dosing group showed significantly better MEMS Dose Adherence (P = .001), whereas MEMS Timing Adherence showed a tendency toward better adherence for this group, but was not significant (P = .052). MEMS Days Adherent (P = .418), MPR% (P = .123), and self-reported adherence (P = .284) did not differ between the once- and twice-daily dosing groups when measured as continuous variables. The MPR% was significantly better for the once-daily dosing group when measured dichotomously but not continuously (P = .044). Notably, most of those exposed to once-daily dosing (63.2%) preferred this to the twice-daily regimen.LimitationsLimitations included small sample size and short follow-up period, precluding the examination of clinical outcome differences.ConclusionsResults for dose adherence replicate the finding that dose simplification increases adherence to immunosuppressants as measured through electronic monitoring. Such an advantage for the once-daily dosing group was not seen across the 2 other electronic monitoring measurement variables (days and timing adherence). This study extends previous research by examining adherence in once versus twice-daily dosing via prescription refill data in a Canadian sample. Given the gravity of potential health outcomes associated with nonadherence, although results indicate inconsistencies in significance testing across measurement methods, the medium to large effect sizes seen in the data favoring better adherence with once-daily dosing provide an indication of the potential clinical significance of these findings.Trial registrationThis study was registered with ClinicalTrials.gov (NCT01334333) on April 11, 2011.

Dataset Information

Impact of once-daily versus twice-daily dosing frequency on adherence to chronic medications among patients with venous thromboembolism.

Background

Objective

Methods

Results

Conclusions

Publications

Impact of once-daily versus twice-daily dosing frequency on adherence to chronic medications among patients with venous thromboembolism.

Similar Datasets

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