Annie R Peng1, Bernard Le Foll2, Mark Morales3, Caryn Lerman4, Robert Schnoll5, Rachel F Tyndale6. 1. Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada. Electronic address: a.peng@mail.utoronto.ca. 2. Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada. Electronic address: bernard.LeFoll@camh.ca. 3. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States. Electronic address: Mark.Morales@uphs.upenn.edu. 4. Department of Psychiatry, Annenberg School for Communication, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, United States. Electronic address: clerman@upenn.edu. 5. Department of Psychiatry and Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, United States. Electronic address: schnoll@pennmedicine.upenn.edu. 6. Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada. Electronic address: r.tyndale@utoronto.ca.
Abstract
INTRODUCTION: We previously reported poor associations between salivary varenicline and pill counts, and a substantial overestimation of adherence by pill counts in "Measures and predictors of varenicline adherence in the treatment of nicotine dependence" (Peng et al., 2017). We have since conducted supplementary analyses characterizing, and then excluding, individuals with established inaccurate pill count recall. METHODS: Based on published varenicline pharmacokinetics (including drug levels, and the long half-life) and our detection limits, conservatively we should be able to detect varenicline in anyone who took at least one pill during the 48h prior to saliva collection; thus, those reporting 1 or more pills in this time frame but who had undetectable salivary varenicline were deemed to have inaccurate pill count recall. Correlations between pill counts and salivary varenicline, and Receiver Operating Characteristics curve analyses were conducted following exclusion of participants with inaccurate pill count recall. RESULTS: Nearly 20% of our participants (N=67/376) had inaccurate self-reported pill counts. These participants were younger, non-white, lower income, and unmarried (evaluated using chi-square or Mann-Whitney U test). Following exclusion of these individuals, the correlations between salivary varenicline and pill count improved and the area under the curve (AUC) of pill counts for discriminating adherence improved modestly. CONCLUSION: When the 20% of individuals with inaccurate pill count recall were excluded, an improved association between self-reported pill count and salivary varenicline was observed, albeit still weak. A substantial overestimation of adherence by pill counts relative to salivary varenicline is still observed even after exclusion of almost 20% of the group having established inaccurate reporting suggesting that these individuals, with identifiable inaccuracies, were only part of the overestimation of adherence.
INTRODUCTION: We previously reported poor associations between salivary varenicline and pill counts, and a substantial overestimation of adherence by pill counts in "Measures and predictors of varenicline adherence in the treatment of nicotine dependence" (Peng et al., 2017). We have since conducted supplementary analyses characterizing, and then excluding, individuals with established inaccurate pill count recall. METHODS: Based on published varenicline pharmacokinetics (including drug levels, and the long half-life) and our detection limits, conservatively we should be able to detect varenicline in anyone who took at least one pill during the 48h prior to saliva collection; thus, those reporting 1 or more pills in this time frame but who had undetectable salivary varenicline were deemed to have inaccurate pill count recall. Correlations between pill counts and salivary varenicline, and Receiver Operating Characteristics curve analyses were conducted following exclusion of participants with inaccurate pill count recall. RESULTS: Nearly 20% of our participants (N=67/376) had inaccurate self-reported pill counts. These participants were younger, non-white, lower income, and unmarried (evaluated using chi-square or Mann-Whitney U test). Following exclusion of these individuals, the correlations between salivary varenicline and pill count improved and the area under the curve (AUC) of pill counts for discriminating adherence improved modestly. CONCLUSION: When the 20% of individuals with inaccurate pill count recall were excluded, an improved association between self-reported pill count and salivary varenicline was observed, albeit still weak. A substantial overestimation of adherence by pill counts relative to salivary varenicline is still observed even after exclusion of almost 20% of the group having established inaccurate reporting suggesting that these individuals, with identifiable inaccuracies, were only part of the overestimation of adherence.
Authors: Annie R Peng; Robert Schnoll; Larry W Hawk; Paul Cinciripini; Tony P George; Caryn Lerman; Rachel F Tyndale Journal: Drug Alcohol Depend Date: 2018-06-26 Impact factor: 4.492
Authors: Annie R Peng; Walter Swardfager; Neal L Benowitz; Jasjit S Ahluwalia; Caryn Lerman; Nicole L Nollen; Rachel F Tyndale Journal: Addiction Date: 2019-11-05 Impact factor: 6.526
Authors: Grace Crawford; Nancy Jao; Annie R Peng; Frank Leone; Ravi Kalhan; Rachel F Tyndale; Jessica Weisbrot; Brian Hitsman; Robert Schnoll Journal: Addict Behav Rep Date: 2018-07-04