Impact of Once-Daily Versus Twice-Daily Dosing Frequency on Adherence to Chronic Medications among Patients with Venous Thromboembolism

Abstract

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.

A Meta-Analysis of Randomized Controlled Trials of the Risk of Bleeding With Apixaban Versus Vitamin K Antagonists

“…Taking a single dose in the morning is easier and more practical for patients, increasing the likelihood of adherence, compared with taking 2 doses daily. 23 Our study has a number of potential limitations. First, in the 2 trials conducted on patients affected by VTE, lowmolecular-weight heparin was used initially during VKA dose titration.…”

Adherence to therapies for secondary prevention of cardiovascular disease: a focus on aspirin

“…In patients taking chronic therapy for CVD, frequency of dosing was inversely related to adherence: the higher the dosing frequency, the lower the patient adherence . In a study of 91 patients with diabetes using oral antidiabetic agents, adherence to oral treatments taken 3 times daily was 38%, compared with 79% for once‐daily therapy .…”

“…In a study of 91 patients with diabetes using oral antidiabetic agents, adherence to oral treatments taken 3 times daily was 38%, compared with 79% for once‐daily therapy . Patients with pulmonary embolism and deep vein thrombosis were 62% more likely to be adherent to their once‐daily treatment than those who received twice‐daily dosing ( P <.001 for both comparisons) …”

Adherence to the Use of New Oral Anticoagulants in Patients With Atrial Fibrillation – the Way to Solve the Problem of Efficacy and Safety of Treatment

“…В целом данные из всех областей фармакотерапии показывают, что более простые схемы с менее частым режимом дозирования ассоциируются с большей при-верженностью к лечению [55][56][57][58]. Данные системати-ческого обзора литературы о приверженности к ле-карственной терапии при различных заболеваниях показали, что при однократном назначении препара-тов отмечаются самые высокие показатели привер-женности в отношении факта приема, соблюдения дозы и времени ее приема по сравнению с множе-ственным дозированием [55].…”

“…Приверженность к приему препарата 1 р/д лучше, не-зависимо от способа ее оценки: путем подсчета из-влечений таблетки из упаковки, количества дней, в тече-ние которых соблюдался режим дозирования или со-блюдения сроков приема, близких к рекомендованным интервалам между введениями [57]. У пациентов, пе-ренесших венозную тромбоэмболию, приверженность к длительному лечению гипогликемическими или ан-тигипертензивными препаратами при однократном приеме в сутки оказалась значительно выше (на 39-61%; р<0,001), чем при двукратном, не зависела от способа ее оценки [58].…”