Yu-Chen Yeh1, Joseph C Cappelleri2, Xiaocong L Marston3, Ahmed Shelbaya4,5. 1. Pharmerit International, Newton, MA, United States of America. 2. Department of Global Biometrics and Data Management, Pfizer Inc, New York, NY, United States of America. 3. Pharmerit International, Shanghai, China. 4. Department of Health Economics and Outcomes Research, Pfizer Inc, New York, NY, United States of America. 5. Mailman School of Public Health, Columbia University, New York, NY, United States of America.
Abstract
OBJECTIVE: To examine pregabalin dose titration and its impact on treatment adherence and duration in patients with neuropathic pain (NeP). METHODS: MarketScan database (2009-2014) was used to extract a cohort of incident adult pregabalin users with NeP who had at least 12 months of follow-up data. Any dose augmentation within 45 days following the first pregabalin claim was defined as dose titration. Adherence (measured by medication possession ratio/MPR) and persistence (measured as the duration of continuous treatment) were compared between the cohorts with and without dose titration. Logistic regressions and Cox proportional hazards models were used to identify the factors associated with adherence (MPR ≥ 0.8) and predictors of time to discontinuation. RESULTS: Among the 5,186 patients in the analysis, only 18% of patients had dose titration. Patients who had dose titration were approximately 2.6 times as likely to be adherent (MPR ≥ 0.8) (odds ratio = 2.59, P < 0.001) than those who did not have dose titration. Kaplan-Meier analysis shows that the time to discontinuation or switch was significantly longer among patients who had dose titration (4.99 vs. 4.04 months, P = 0.009). CONCLUSIONS: Dose titration was associated with improved treatment adherence and persistence among NeP patients receiving pregabalin. The findings will provide valuable evidence to increase physician awareness of dose recommendations in the prescribing information and to educate patients on the importance of titration and adherence.
OBJECTIVE: To examine pregabalin dose titration and its impact on treatment adherence and duration in patients with neuropathic pain (NeP). METHODS: MarketScan database (2009-2014) was used to extract a cohort of incident adult pregabalin users with NeP who had at least 12 months of follow-up data. Any dose augmentation within 45 days following the first pregabalin claim was defined as dose titration. Adherence (measured by medication possession ratio/MPR) and persistence (measured as the duration of continuous treatment) were compared between the cohorts with and without dose titration. Logistic regressions and Cox proportional hazards models were used to identify the factors associated with adherence (MPR ≥ 0.8) and predictors of time to discontinuation. RESULTS: Among the 5,186 patients in the analysis, only 18% of patients had dose titration. Patients who had dose titration were approximately 2.6 times as likely to be adherent (MPR ≥ 0.8) (odds ratio = 2.59, P < 0.001) than those who did not have dose titration. Kaplan-Meier analysis shows that the time to discontinuation or switch was significantly longer among patients who had dose titration (4.99 vs. 4.04 months, P = 0.009). CONCLUSIONS: Dose titration was associated with improved treatment adherence and persistence among NeP patients receiving pregabalin. The findings will provide valuable evidence to increase physician awareness of dose recommendations in the prescribing information and to educate patients on the importance of titration and adherence.
Authors: Troels S Jensen; Ralf Baron; Maija Haanpää; Eija Kalso; John D Loeser; Andrew S C Rice; Rolf-Detlef Treede Journal: Pain Date: 2011-07-18 Impact factor: 6.961
Authors: John E Zeber; Elizabeth Manias; Allison F Williams; David Hutchins; Waka A Udezi; Craig S Roberts; Andrew M Peterson Journal: Value Health Date: 2013-07-10 Impact factor: 5.725
Authors: Nanna B Finnerup; Nadine Attal; Simon Haroutounian; Ewan McNicol; Ralf Baron; Robert H Dworkin; Ian Gilron; Maija Haanpää; Per Hansson; Troels S Jensen; Peter R Kamerman; Karen Lund; Andrew Moore; Srinivasa N Raja; Andrew S C Rice; Michael Rowbotham; Emily Sena; Philip Siddall; Blair H Smith; Mark Wallace Journal: Lancet Neurol Date: 2015-01-07 Impact factor: 44.182