Swiss Priority Setting on Implementing Medication Adherence Interventions as Part of the European ENABLE COST Action

Bandiera, Carole; Ribaut, Janette; Dima, A.; Allemann, Samuel; Molesworth, Kate; Kalumiya, Kabeza; Käser, Fabian; Olson, Mark W.; Burnier, Michel; Boven, Job F M van; Szucs, Thomas D.; Albrecht, Daniel; Wilson, Ira B.; Geest, Sabina De; Schneider, M.

doi:10.3389/ijph.2022.1605204

Cited by 6 publications

(3 citation statements)

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“…For example, early in their therapeutic itinerary, polypharmacy patients would be invited to experience the IMAP for 12 months to co-construct their medication adherence with healthcare providers, tailored to their individual needs, before deciding whether they would benefit from continuing the intervention or repeating it later based on defined clinical outcomes, personal experiences, and indicators ( Bandiera et al, 2022a ). The interprofessional collaborations between patients, pharmacists, physicians, nurses, and other healthcare providers should be strengthened in order to synergistically promote the IMAP to patients and to better define the roles and responsibilities of each healthcare provider in supporting medication adherence ( Bandiera et al, 2022c ).…”

Section: Discussionmentioning

confidence: 99%

The differential impact of a 6-versus 12-month pharmacist-led interprofessional medication adherence program on medication adherence in patients with diabetic kidney disease: the randomized PANDIA-IRIS study

Bandiera,

Dotta-Celio,

Locatelli

et al. 2024

Front. Pharmacol.

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Background: For every 100 patients with diabetes, 40 will develop diabetic kidney disease (DKD) over time. This diabetes complication may be partly due to poor adherence to their prescribed medications. In this study, we aimed to evaluate the differential impact of a 6- versus 12-month pharmacist-led interprofessional medication adherence program (IMAP) on the components of adherence (i.e., implementation and discontinuation) in patients with DKD, during and after the intervention.Methods: All included patients benefited from the IMAP, which consists in face-to-face regular motivational interviews between the patient and the pharmacist based on the adherence feedback from electronic monitors (EMs), in which the prescribed treatments were delivered. Adherence reports were available to prescribers during the intervention period. Patients were randomized 1:1 into two parallel arms: a 12-month IMAP intervention in group A versus a 6-month intervention in group B. Adherence was monitored continuously for 24 months post-inclusion during the consecutive intervention and follow-up phases. In the follow-up phase post-intervention, EM data were blinded. Blood pressure was measured by the pharmacist at each visit. The repeated measures of daily patient medication intake outcomes (1/0) to antidiabetics, antihypertensive drugs, and statins were modeled longitudinally using the generalized estimated equation in both groups and in both the intervention and the follow-up phases.Results: EM data of 72 patients were analyzed (34 in group A and 38 in group B). Patient implementation to antidiabetics and antihypertensive drugs increased during the IMAP intervention phase and decreased progressively during the follow-up period. At 12 months, implementation to antidiabetics was statistically higher in group A versus group B (93.8% versus 86.8%; Δ 7.0%, 95% CI: 5.7%; 8.3%); implementation to antihypertensive drugs was also higher in group A versus B (97.9% versus 92.1%; Δ 5.8%, 95% CI: 4.8%; 6.7%). At 24 months, implementation to antidiabetics and antihypertensive drugs remained higher in group A versus B (for antidiabetics: 88.6% versus 85.6%; Δ 3.0%, 95% CI: 1.7%; 4.4% and for antihypertensive drugs: 94.4% versus 85.9%; Δ 8.5%, 95% CI: 6.6%; 10.7%). No difference in pharmacy-based blood pressure was observed between groups. Implementation to statins was comparable at each time point between groups. Three patients discontinued at least one treatment; they were all in group B. In total, 46% (16/35) of patients in the 12-month intervention versus 37% (14/38) of patients in the 6-month intervention left the study during the intervention phase, mainly due to personal reasons.Conclusion: The IMAP improves adherence to chronic medications in patients with DKD. The longer the patients benefit from the intervention, the more the implementation increases over time, and the more the effect lasts after the end of the intervention. These data suggest that a 12-month rather than a 6-month program should be provided as a standard of care to support medication adherence in this population. The impact on clinical outcomes needs to be demonstrated.Clinical Trial Registration:Clinicaltrials.gov, identifier NCT04190251_PANDIA IRIS.

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Section: Discussionmentioning

confidence: 99%

The differential impact of a 6-versus 12-month pharmacist-led interprofessional medication adherence program on medication adherence in patients with diabetic kidney disease: the randomized PANDIA-IRIS study

Bandiera,

Dotta-Celio,

Locatelli

et al. 2024

Front. Pharmacol.

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“…Similarly, CoEs are perfectly placed to provide professional communication to the general public and, last but not least, advocacy. Many of these aims are interdisciplinary, such as the development and adaptation of high-quality, evidence-based clinical practice guidelines, as well as the tools for the dissemination and implementation of this guidance, with the ultimate aim of translation of medication adherence interventions into clinical practice [ 17 , 18 ]. Therefore, in the case of medication adherence research, a CoE’s interdisciplinarity is not simply a challenge but a fundamental necessity.…”

Section: Scope Of the Centrementioning

confidence: 99%

Half a Century of Fragmented Research on Deviations from Advised Therapies: Is This a Good Time to Call for Multidisciplinary Medication Adherence Research Centres of Excellence?

et al. 2023

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Medication adherence is a key precondition of the effectiveness of evidence-based therapies. However, in real-life settings, non-adherence to medication is still very common. This leads to profound health and economic consequences at both individual and public health levels. The problem of non-adherence has been extensively studied in the last 50 years. Unfortunately, with more than 130,000 scientific papers published on that subject so far, we are still far from finding an ultimate solution. This is, at least partly, due to fragmented and poor-quality research that has been conducted in this field sometimes. To overcome this deadlock, there is a need to stimulate the adoption of best practices in medication adherence-related research in a systematic way. Therefore, herein we propose the establishment of dedicated medication adherence research Centres of Excellence (CoEs). These Centres could not only conduct research but could also create a profound societal impact, directly serving the needs of patients, healthcare providers, systems and economies. Additionally, they could play a role as local advocates for good practices and education. In this paper, we propose some practical steps that might be taken in order to establish such CoEs. We describe two success stories, i.e., Dutch and Polish Medication Adherence Research CoEs. The COST Action “European Network to Advance Best practices & technoLogy on medication adherencE” (ENABLE) aims to develop a detailed definition of the Medication Adherence Research CoE in the form of a list of minimal requirements regarding their objectives, structure and activities. We hope that it will help to create a critical mass and catalyse the setup of regional and national Medication Adherence Research CoEs in the near future. This, in turn, may not only increase the quality of the research but also raise the awareness of non-adherence and promote the adoption of the best medication adherence-enhancing interventions.

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“…In the past decade, digital technologies—such as mobile apps, EMs, ingestible sensors, weekly electronic pillboxes, blister pack technologies, electronic patient self-report diaries, or insurance claim databases [ 13 ]—have been increasingly used to measure real-time components of adherence (ie, initiation, implementation, and persistence [ 5 ]). Digital health innovations and technologies can be used to contribute and facilitate interventions aiming at supporting medication adherence [ 14 ]. In parallel, the quality of adherence data analysis has increased due to guidelines on operational adherence definitions [ 15 ], advanced statistical analysis [ 16 , 17 ], and semiautomated procedures to analyze adherence in health care databases (eg, the Adhere-R package [ 18 ]).…”

Section: Introductionmentioning

confidence: 99%

Using a Semiautomated Procedure (CleanADHdata.R Script) to Clean Electronic Adherence Monitoring Data: Tutorial

Bandiera,

Pasquier,

Locatelli

et al. 2024

JMIR Form Res

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Background Patient adherence to medications can be assessed using interactive digital health technologies such as electronic monitors (EMs). Changes in treatment regimens and deviations from EM use over time must be characterized to establish the actual level of medication adherence. Objective We developed the computer script CleanADHdata.R to clean raw EM adherence data, and this tutorial is a guide for users. Methods In addition to raw EM data, we collected adherence start and stop monitoring dates and identified the prescribed regimens, the expected number of EM openings per day based on the prescribed regimen, EM use deviations, and patients’ demographic data. The script formats the data longitudinally and calculates each day’s medication implementation. Results We provided a simulated data set for 10 patients, for which 15 EMs were used over a median period of 187 (IQR 135-342) days. The median patient implementation before and after EM raw data cleaning was 83.3% (IQR 71.5%-93.9%) and 97.3% (IQR 95.8%-97.6%), respectively (Δ+14%). This difference is substantial enough to consider EM data cleaning to be capable of avoiding data misinterpretation and providing a cleaned data set for the adherence analysis in terms of implementation and persistence. Conclusions The CleanADHdata.R script is a semiautomated procedure that increases standardization and reproducibility. This script has broader applicability within the realm of digital health, as it can be used to clean adherence data collected with diverse digital technologies.

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Swiss Priority Setting on Implementing Medication Adherence Interventions as Part of the European ENABLE COST Action

Cited by 6 publications

References 8 publications

The differential impact of a 6-versus 12-month pharmacist-led interprofessional medication adherence program on medication adherence in patients with diabetic kidney disease: the randomized PANDIA-IRIS study

The differential impact of a 6-versus 12-month pharmacist-led interprofessional medication adherence program on medication adherence in patients with diabetic kidney disease: the randomized PANDIA-IRIS study

Half a Century of Fragmented Research on Deviations from Advised Therapies: Is This a Good Time to Call for Multidisciplinary Medication Adherence Research Centres of Excellence?

Using a Semiautomated Procedure (CleanADHdata.R Script) to Clean Electronic Adherence Monitoring Data: Tutorial

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