This study demonstrates that nonvalvular AF patients treated with q.d. dosing regimens for chronic medications were associated with approximately a 26% higher likelihood of adherence compared with subjects on b.i.d. regimens.

BackgroundMultiple daily dosing may be negatively associated with patient medication adherence; however, adherence-related data are lacking in a patient population with venous thromboembolism (VTE).ObjectiveTo assess the adherence rates between once-daily (OD) and twice-daily (BID) dosing regimens of chronic medications in patients with VTE.MethodsWe 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.ResultsA 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).ConclusionsThis 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.Electronic supplementary materialThe online version of this article (doi:10.1007/s40271-013-0020-5) contains supplementary material, which is available to authorized users.

Traditional major cardiovascular risk factors are also predictive of MI in VTE patients. Having multiple major risk factors significantly increases the probability of developing MI events in VTE patients.

- Moss microbial communities play important roles for ecosystem processes in boreal forests. Host identity and leaf litter presence can affect microbial community structures of mosses. However, the extent to which host-specific characteristics and land use type affect taxonomic and functional profiles of microbial communities of boreal mosses is still poorly understood. - We used shotgun metagenomic sequencing to characterize microbial taxonomy and metabolic KEGG ortholog (KO) profiles between green and brown sections of five moss species across different natural sites, and two moss species between a natural site and a mine site in Eeyou Istchee, Quebec, Canada. - Our results demonstrate that the abundance of nitrogen metabolic genes differ between moss sections and that mosses from natural and mine environment associate with different microbial taxa and KO profiles. Importantly, conditions at the mine site appear to favor microbial taxa that can tolerate perturbated environments, including taxa that can oxidize sulfur and participate in biofilm formation. - Overall, our results highlight that moss section, moss species identity, and land-use type are strong drivers of diversity and community structure of moss-associated microbial taxa and metabolic genes. These findings could have major implications for boreal forests facing climate change and anthropogenic pressures