Dana Ben-Ami Shor1,2, Dahlia Weitzman1,2, Shani Dahan1,2, Omer Gendelman1,2, Yael Bar-On1,2, Daniela Amital1,2, Varda Shalev1,2, Gabriel Chodick1,2, Howard Amital3,4. 1. From the Department of Gastroenterology, Sheba Medical Center; Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center; Sackler Faculty of Medicine, Tel Aviv University; Maccabitech, Maccabi Healthcare Services; Department of Medicine E, Tel Aviv Sourasky Medical Center, Tel Aviv; Beer-Yaakov/Ness-Ziona, Mental Health Center, Beer-Yaakov, Israel. 2. D. Ben-Ami Shor, MD, Department of Gastroenterology, Sheba Medical Center, and Sackler Faculty of Medicine, Tel Aviv University; D. Weitzman, PhD, Sackler Faculty of Medicine, Tel Aviv University, and Maccabitech, Maccabi Healthcare Services; S. Dahan, MD, Sackler Faculty of Medicine, Tel Aviv University, and Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center; O. Gendelman MD, Sackler Faculty of Medicine, Tel Aviv University, and Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center; Y. Bar-On, MD, Sackler Faculty of Medicine, Tel Aviv University, and Department of Medicine E, Tel Aviv Sourasky Medical Center; D. Amital, MD, MHA, Sackler Faculty of Medicine, Tel Aviv University, and Beer-Yaakov/Ness-Ziona, Mental Health Center; V. Shalev, MD, Sackler Faculty of Medicine, Tel Aviv University, and Maccabitech, Maccabi Healthcare Services; G. Chodick, PhD, Sackler Faculty of Medicine, Tel Aviv University, and Maccabitech, Maccabi Healthcare Services; H. Amital, MD, MHA, Sackler Faculty of Medicine, Tel Aviv University, and Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center. Dr. Ben-Ami Shor and Dr. Weitzman are co-first authors and have contributed equally to this work. 3. From the Department of Gastroenterology, Sheba Medical Center; Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center; Sackler Faculty of Medicine, Tel Aviv University; Maccabitech, Maccabi Healthcare Services; Department of Medicine E, Tel Aviv Sourasky Medical Center, Tel Aviv; Beer-Yaakov/Ness-Ziona, Mental Health Center, Beer-Yaakov, Israel. howard.amital@sheba.health.gov.il. 4. D. Ben-Ami Shor, MD, Department of Gastroenterology, Sheba Medical Center, and Sackler Faculty of Medicine, Tel Aviv University; D. Weitzman, PhD, Sackler Faculty of Medicine, Tel Aviv University, and Maccabitech, Maccabi Healthcare Services; S. Dahan, MD, Sackler Faculty of Medicine, Tel Aviv University, and Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center; O. Gendelman MD, Sackler Faculty of Medicine, Tel Aviv University, and Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center; Y. Bar-On, MD, Sackler Faculty of Medicine, Tel Aviv University, and Department of Medicine E, Tel Aviv Sourasky Medical Center; D. Amital, MD, MHA, Sackler Faculty of Medicine, Tel Aviv University, and Beer-Yaakov/Ness-Ziona, Mental Health Center; V. Shalev, MD, Sackler Faculty of Medicine, Tel Aviv University, and Maccabitech, Maccabi Healthcare Services; G. Chodick, PhD, Sackler Faculty of Medicine, Tel Aviv University, and Maccabitech, Maccabi Healthcare Services; H. Amital, MD, MHA, Sackler Faculty of Medicine, Tel Aviv University, and Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center. Dr. Ben-Ami Shor and Dr. Weitzman are co-first authors and have contributed equally to this work. howard.amital@sheba.health.gov.il.
Abstract
OBJECTIVE: To assess 1-year persistence and adherence rates with drug therapy among patients with fibromyalgia (FM) and to identify factors associated with therapy discontinuation. METHODS: This retrospective, cohort study included members ≥ 21 years old from the Maccabi Healthcare Services, a large health maintenance organization in Israel, who were diagnosed with FM from 2008 through 2011. Medications of interest included the anticonvulsant pregabalin, antidepressants [selective serotonin reuptake inhibitor (SSRI), serotonin/norepinephrine reuptake inhibitor (SNRI)], and tricyclic antidepressants (TCA). Time to treatment discontinuation and proportion of days covered (PDC) with FM-specific therapies during the year from first dispensed were analyzed. PDC < 20% was considered low adherence and PDC ≥ 80% was considered high adherence. Logistic regression models were constructed for multivariable analyses. RESULTS: Overall, 3932 patients with FM were included; 88.7% were female. Pre-diagnosis use of medication of interest was documented in 41% of the study population. Of the remaining 2312 patients, 56.1% were issued a prescription, 45.0% were dispensed at least 1 medication in the year following diagnosis, and only 28.8% had prescriptions filled twice within the first year from diagnosis. Among newly prescribed patients, 1-year discontinuation was highest for TCA (91.0%) and lowest for SSRI/SNRI antidepressants (73.7%). Over half of the patients (60.5%) had fewer than 20% of the days covered by any medication during the year and only 9.3% were very adherent (PDC ≥ 80%). CONCLUSION: This study clearly shows that in an Israeli "real-life" population of patients with FM, persistence and adherence with FM therapy in the year following diagnosis is remarkably low.
OBJECTIVE: To assess 1-year persistence and adherence rates with drug therapy among patients with fibromyalgia (FM) and to identify factors associated with therapy discontinuation. METHODS: This retrospective, cohort study included members ≥ 21 years old from the Maccabi Healthcare Services, a large health maintenance organization in Israel, who were diagnosed with FM from 2008 through 2011. Medications of interest included the anticonvulsant pregabalin, antidepressants [selective serotonin reuptake inhibitor (SSRI), serotonin/norepinephrine reuptake inhibitor (SNRI)], and tricyclic antidepressants (TCA). Time to treatment discontinuation and proportion of days covered (PDC) with FM-specific therapies during the year from first dispensed were analyzed. PDC < 20% was considered low adherence and PDC ≥ 80% was considered high adherence. Logistic regression models were constructed for multivariable analyses. RESULTS: Overall, 3932 patients with FM were included; 88.7% were female. Pre-diagnosis use of medication of interest was documented in 41% of the study population. Of the remaining 2312 patients, 56.1% were issued a prescription, 45.0% were dispensed at least 1 medication in the year following diagnosis, and only 28.8% had prescriptions filled twice within the first year from diagnosis. Among newly prescribed patients, 1-year discontinuation was highest for TCA (91.0%) and lowest for SSRI/SNRI antidepressants (73.7%). Over half of the patients (60.5%) had fewer than 20% of the days covered by any medication during the year and only 9.3% were very adherent (PDC ≥ 80%). CONCLUSION: This study clearly shows that in an Israeli "real-life" population of patients with FM, persistence and adherence with FM therapy in the year following diagnosis is remarkably low.
Authors: N Samartin-Veiga; A J González-Villar; M Pidal-Miranda; A Vázquez-Millán; M T Carrillo-de-la-Peña Journal: Qual Life Res Date: 2022-03-01 Impact factor: 3.440
Authors: Mateus B Souza; Rodrigo O Mascarenhas; Laisa B Maia; Letícia S Fonseca; Hytalo J Silva; Rutger M J de Zoete; James H McAuley; Nicholas Henschke; Vinicius C Oliveira Journal: PLoS One Date: 2022-10-03 Impact factor: 3.752
Authors: Robert N Jamison; Robert R Edwards; Samantha Curran; Limeng Wan; Edgar L Ross; Christopher J Gilligan; Shai N Gozani Journal: J Pain Res Date: 2021-07-24 Impact factor: 3.133