Carol A Forbes1, Sohan Deshpande1, Francesc Sorio-Vilela2, Lucie Kutikova2, Steven Duffy1, Ioanna Gouni-Berthold3, Emil Hagström4. 1. a Kleijnen Systematic Reviews Ltd , York , UK. 2. b Global Health Economics, Amgen (Europe) GmbH , Zug , Switzerland. 3. c Polyclinic for Endocrinology, Diabetes and Preventive Medicine , University of Cologne , Cologne , Germany. 4. d Uppsala Clinical Research Center (UCR), Department of Medical Sciences , University of Uppsala , Uppsala , Sweden.
Abstract
OBJECTIVES: A systematic literature review was conducted comparing different approaches estimating persistence and adherence in chronic diseases with polypharmacy of oral and subcutaneous treatments. METHODS: This work followed published guidance on performing systematic reviews. Twelve electronic databases and grey literature sources were used to identify studies and guidelines for persistence and adherence of oral and subcutaneous therapies in hypercholesterolemia, type 2 diabetes, hypertension, osteoporosis and rheumatoid arthritis. Outcomes of interest of each persistence and adherence data collection and calculation method included pros: accurate, easy to use, inexpensive; and cons: inaccurate, difficult to use, expensive. RESULTS: A total of 4158 records were retrieved up to March 2017. We included 16 observational studies, 5 systematic reviews and 7 guidelines, in patients with hypercholesterolemia (n = 8), type 2 diabetes (n = 4), hypertension (n = 2), rheumatoid arthritis (n = 1) and mixed patient populations (n = 13). Pharmacy and medical records offer an accurate, easy and inexpensive data collection method. Pill count, medication event monitoring systems (MEMs), self-report questionnaires and observer report are easy to use. MEMS and biochemical monitoring tests can be expensive. Proportion of days covered (PDC) was recommended as a gold standard calculation method for long-term treatments. PDC avoids use of days' supply in calculation, hence is more accurate compared to medication possession ratio (MPR) to assess adherence to treatments in chronic diseases. CONCLUSIONS: Decisions on what method to use should be based on considerations of the route of medication administration, the resources available, setting and aim of the assessment. Combining different methods may provide wider insights into adherence and persistence, including patient behavior.
OBJECTIVES: A systematic literature review was conducted comparing different approaches estimating persistence and adherence in chronic diseases with polypharmacy of oral and subcutaneous treatments. METHODS: This work followed published guidance on performing systematic reviews. Twelve electronic databases and grey literature sources were used to identify studies and guidelines for persistence and adherence of oral and subcutaneous therapies in hypercholesterolemia, type 2 diabetes, hypertension, osteoporosis and rheumatoid arthritis. Outcomes of interest of each persistence and adherence data collection and calculation method included pros: accurate, easy to use, inexpensive; and cons: inaccurate, difficult to use, expensive. RESULTS: A total of 4158 records were retrieved up to March 2017. We included 16 observational studies, 5 systematic reviews and 7 guidelines, in patients with hypercholesterolemia (n = 8), type 2 diabetes (n = 4), hypertension (n = 2), rheumatoid arthritis (n = 1) and mixed patient populations (n = 13). Pharmacy and medical records offer an accurate, easy and inexpensive data collection method. Pill count, medication event monitoring systems (MEMs), self-report questionnaires and observer report are easy to use. MEMS and biochemical monitoring tests can be expensive. Proportion of days covered (PDC) was recommended as a gold standard calculation method for long-term treatments. PDC avoids use of days' supply in calculation, hence is more accurate compared to medication possession ratio (MPR) to assess adherence to treatments in chronic diseases. CONCLUSIONS: Decisions on what method to use should be based on considerations of the route of medication administration, the resources available, setting and aim of the assessment. Combining different methods may provide wider insights into adherence and persistence, including patient behavior.
Authors: Amanda M Kibbons; Megan Peter; Josh DeClercq; Leena Choi; Jacob Bell; Jacob Jolly; Elizabeth Cherry; Bassel Alhashemi; Nisha B Shah; Autumn D Zuckerman Journal: Drugs Real World Outcomes Date: 2020-09-21
Authors: Md Ashraful Islam; Zeb-Un- Nisa; Abdullah Isa Almuzel; Hani Sadiq Al Afif; Laila Hussain Al Rabia; Muhammad Shahid Iqbal; Azfar Athar Ishaqui; Muhammad Zahid Iqbal; Mohammad Akbar Hossain; Abdul Haseeb; Shazia Jamshed; Atta Abbas Naqvi; Sunil Kripalani Journal: Saudi Pharm J Date: 2021-07-15 Impact factor: 4.330