<p>Adherence to long-term therapies in cystic fibrosis: a French cross-sectional study linking prescribing, dispensing, and hospitalization data</p>

Abstract

Background Cystic fibrosis (CF) is a life-shortening genetic condition that usually affects several organs and involves significant treatment burden. Adherence to medication is important for successful CF management. Objective To describe medication adherence according to age, therapeutic class, and pharmaceutical form in adults and children followed in four regional CF centers in France. Methods We conducted a cross-sectional study with non-transplanted patients followed in two adult and two pediatric centers during 2015 who were covered by the French National Health Insurance (NHI). Sociodemographic, clinical, hospitalization, and prescription data were collected from patient medical records. Medication dispensations were extracted from the regional French NHI database. Adherence was calculated over 12 months using continuous medication availability (CMA) accounting for dose adjustments and hospitalizations. Drug-specific CMA was computed in R with the AdhereR package for each medication prescribed more than 3 months, which was averaged to obtain a composite CMA score (cCMA) for all treatments and per therapeutic class as well as pharmaceutical form for each patient. Results A total of 228 patients were included. The number of chronic medications increased with age ( r =0.50, p <0.001): a median of 7 medications per patient were prescribed. The mean±SD cCMA was significantly different between age groups ( p =0.0098): it was 0.71±0.20 for the 0–5 years age group, 0.73±0.16 for 6–11 years, 0.64±0.17 for 12–17 years, 0.57±0.23 for 18–25 years, and 0.65±0.20 for the over 25 years age group. cCMA varied significantly according to pharmaceutical forms: the mean±SD cCMA was 0.70±0.21 for oral medications and 0.54±0.28 for inhaled medications ( p <0.001). Conclusion This study suggests that adherence to medication regimens in CF patients remains suboptimal and varies substantially between age groups and pharmaceutical forms. These variations in adherence should be considered when developing effective strategies to improve adherence.

Use of mucoactive agents in cystic fibrosis: A consensus survey of Italian specialists

“…Mucoactive therapies to augment mucociliary clearance and to control infection and inflammation are prescribed as maintenance therapies to improve lung function and prevent pulmonary exacerbations. Despite the benefits of CF treatments, medication adherence among individuals with CF remains low, ranging from 33% to 76% 49–51 . Adherence of CF adults to medication regimens has been documented as problematic 52,53 …”

“…Despite the benefits of CF treatments, medication adherence among individuals with CF remains low, ranging from 33% to 76%. [49][50][51] Adherence of CF adults to medication regimens has been documented as problematic. 52,53 Poor adherence to medication is associated with adverse clinical outcomes in CF.…”

Use of dornase alfa in cystic fibrosis: an Audit of Italian specialists

“…Mucoactive therapies to augment mucociliary clearance and to control infection and inflammation are prescribed as maintenance therapies to improve lung function and prevent pulmonary exacerbations. Despite the benefits of CF treatments, medication adherence among individuals with CF remains low, ranging from 33% to 76% [46][47][48] . Adherence of CF adults to medication regimens has been documented as problematic 49,50 .…”

Survey and electronic health record‐based medication use agreement in children with cystic fibrosis: A retrospective cross‐sectional study

“…Furthermore, dentists who practice in non‐hospital or integrated clinical settings are not likely to have access to a patient's EHR. Additionally, differential medication adherence may contribute to poor agreement between methods 13‐16 . Collectively, these studies underscore the complexity of collecting accurate medication use data.…”