Improved Adherence to Tacrolimus Once-Daily Formulation in Renal Recipients

Abstract

Regimen implementation of tacrolimus once daily is significantly superior to the twice-daily regimen. There was a residual prevalence of suboptimal adherence that will have to be countered by means other than reformulation and regimen simplification. Electronically compiled dosing histories provide detailed data on patient adherence that can be used for efficient medication management.

A Comparative, Multicenter, Observational Study of Medication Adherence in Liver Cirrhosis Patients and Dialysis Patients Using Electronic Event Measurement

“…The number of dosage forms to be taken per dosing interval is most probably the reason for the lower DA rate of dialysis patients with phosphate binders (43%) compared to the liver cirrhosis patients with the propranolol therapy (61%). It is well known that once or twice daily dosing correlates with higher adherence rates than three times daily dosing [20][21][22]. In this study the adherence rate also correlated negatively with the number of dosage forms of phosphate binders to be taken.…”

“…Moreover, it is well known, that the dosing schedule influences the medication adherence rates and three times daily dosing is unfavourable. In contrast, once daily dosing of tacrolimus came up to a median DA rate of 100% [20][21][22]. The number of dosage forms to be taken per dosing interval is most probably the reason for the lower DA rate of dialysis patients with phosphate binders (43%) compared to the liver cirrhosis patients with the propranolol therapy (61%).…”

Prevention of organ rejection in renal and liver transplantation with extended release tacrolimus

“…79 The number of patients taking the prescribed number of daily doses was significantly higher for TAC QD (88.2% versus 78.8%, P=0.0009). 79 In keeping with data from other studies, patients were less adherent with the evening dose of TAC BID (missed doses: 11.7% morning versus 14.2% evening, P=0.0035).…”

“…78 The effect of tacrolimus conversion on adherence has been assessed in a randomized controlled trial that used electronic recordings of pill bottle opening as an indirect objective measure, coupled with subjective questionnaire interviews. 79 Two hundred and nineteen stable patients were randomized to TAC QD or continuation of TAC BID and followed for 3 months prior to conversion as well as 6 months after. 79 At 6 months, persistence with the prescribed regimen was higher for TAC QD (81.5% versus 71.9%, P=0.0824).…”

“…79 Two hundred and nineteen stable patients were randomized to TAC QD or continuation of TAC BID and followed for 3 months prior to conversion as well as 6 months after. 79 At 6 months, persistence with the prescribed regimen was higher for TAC QD (81.5% versus 71.9%, P=0.0824). 79 The number of patients taking the prescribed number of daily doses was significantly higher for TAC QD (88.2% versus 78.8%, P=0.0009).…”