Utilization of oral antihyperglycemic drugs over a 7–year period (1998–2004) in a Hungarian population and adherence to drug therapy

Doró, Péter; Benkő, Ria; Kosik, Edit; Matuz, Mária; Tóth, Katalin; Soós, Gyöngyvér

doi:10.1007/s00228-005-0031-9

Cited by 32 publications

(25 citation statements)

References 13 publications

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“…Our results regarding other medical and demographic factors confirmed associations observed in IBIS including age and risk of breast cancer. STAR, as well as several studies regarding adjuvant tamoxifen therapy and other medications, found greater persistence or adherence for older patients 5,6,31,34-37 although inverse or U-shaped associations have also been observed. 3,38 Veronesi reported that breast cancer patients taking tamoxifen in an adjuvant therapy trial were more likely to adhere than were women in a chemoprevention trial, which is consistent with our observation that higher perceived health risk increases adherence.…”

Section: Discussionmentioning

confidence: 92%

Cigarette Smoking, Obesity, Physical Activity, and Alcohol Use As Predictors of Chemoprevention Adherence in the National Surgical Adjuvant Breast and Bowel Project P-1 Breast Cancer Prevention Trial

Land

Cronin

Wickerham

et al. 2011

Cancer Prevention Research

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Background The double-blind, prospective, National Surgical Adjuvant Breast and Bowel Project (NSABP) Breast Cancer Prevention Trial (BCPT) demonstrated a 50% reduction in the risk of breast cancer (BC) for tamoxifen versus placebo, yet many women at risk of BC do not adhere to the 5-year course. This first report of the rich BCPT drug adherence data examines predictors of adherence. Methods 13,338 women at high risk of BC were randomly assigned 6/92-9/97 to 20 mg/day tamoxifen versus placebo; we analyzed the 11,064 enrolled more than 3 years before trial unblinding. Primary endpoint was full drug adherence (100% of assigned pills per staff report, excluding protocol-required discontinuation) at 1 and 36 months; secondary was adequate adherence (76-100%). Protocol-specified multivariable logistic regression tested lifestyle factors, controlling for demographic and medical predictors. Results 13% were current smokers. 60% were overweight/obese. 46% had moderate/heavy physical activity. 21%, 66%, 13% drank 0, 0-1, 1+ drinks/day. 91% were adequately adherent at 1 mo; 79% at 3 yrs. Alcohol use was associated with reduced full adherence at 1 mo (p=.016; odds ratio [OR]=0.79 1+ versus 0), as was age (p<.001; OR=1.4 age 60+), college education (p<.001; OR=0.78) and per-capita household annual income (p<.001; OR=1.2 per $30,000). Smoking (p=.003; OR=0.75), age (p=.024, OR=1.1), college education (p=.037; OR=1.4), tamoxifen assignment (p=.031; OR=.84), and BC risk (p<.001; OR=1.5 high v low) predicted adequate adherence at 36 months. There were no significant associations with obesity or physical activity. Conclusions Alcohol use and smoking might indicate a need for greater adherence support.

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Section: Discussionmentioning

confidence: 92%

Cigarette Smoking, Obesity, Physical Activity, and Alcohol Use As Predictors of Chemoprevention Adherence in the National Surgical Adjuvant Breast and Bowel Project P-1 Breast Cancer Prevention Trial

Land

Cronin

Wickerham

et al. 2011

Cancer Prevention Research

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“…Satisfactory refill adherence was defined as dispensed refills covering 100 ± 20% of the prescribed treatment time. This range (80–120%) is commonly used in adherence research (24, 29). A refill adherence of 100% equals the amount of drugs that would last for the entire prescribed treatment time.…”

Section: Methodsmentioning

confidence: 99%

“…In the logistic regression analysis, satisfactory refill adherence and oversupply were grouped together as ‘satisfactory refill adherence’ being compared with ‘undersupply’. In the literature, many studies do not indicate an upper level of refill adherence (24), as oversupply is more difficult to interpret than satisfactory refill adherence and undersupply. Therefore, only satisfactory refill adherence and undersupply are reported.…”

Section: Methodsmentioning

confidence: 99%

Refill adherence by the elderly for asthma/chronic obstructive pulmonary disease drugs dispensed over a 10-year period

Krigsman

Moen

Nilsson³

et al. 2007

J Clin Pharm Ther

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“…Further, because irregular and inconsistent intake of one or more drugs in a polypharmacy regimen is common and may impact on clinical outcomes, assessment of adherence to polypharmacy is clinically relevant. The few studies that have attempted to calculate adherence to several concurrent medications have averaged the indices obtained for each of the single-medications [11–15]. This method has been shown to overestimate [16] but may also underestimate adherence to polypharmacy regimens.…”

Section: Introductionmentioning

confidence: 99%

A method for calculating adherence to polypharmacy from dispensing data records

et al. 2013

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Background Several measures for calculating adherence to one medication from dispensing data records have been proposed, but the nomenclature is inconsistent and computations vary. The same measures, like the medication possession ratio (MPR), have been used for multiple medication regimens, and have tended to over- or under-estimate adherence rates. Objective To demonstrate the impact of varying elements in MPR to a single medication regimen; to define standards for the estimation of adherence to polypharmacy; to propose a new method for calculating adherence to polypharmacy; to face validate it. Setting Face validity of the proposed method. Method Variations in the MPR formula were simulated. Standards for the estimation of adherence to polypharmacy were defined. A new method to calculate adherence to polypharmacy was established. Its face validity with three illustrative cases obtained from a pharmacy refill database was assessed. Main outcome measure Adherence rate to polypharmacy from refill data records. Results MPR to a single medication is operationalized in the numerator and denominator and is influenced by the parameters like observation period, medication gaps, overlap. For polypharmacy, an average MPR is commonly used, which is not accounting for the specificity of multiple medications, and hence overestimating adherence rate. We propose the daily polypharmacy possession ratio (DPPR) as an index of adherence to polypharmacy. It estimates the proportion of time a patient had medication available for use by considering the presence or absence of multiple medications on each day in the observation period. We calculated possession rates from refill histories over 31 months (January 1, 2011–July 31, 2013) for three illustrative patients. The average MPR estimates were 80 % for a patient with 6 medications/20 refill dates, 90 % for a patient with 4 medications/11 refill dates, and 89 % for a patient with 3 medications/17 refill dates. The corresponding DPPRs were 75, 88 and 99 %, indicating overestimations by 5 and 2 %, and underestimation by 10 %, respectively. Conclusion The DPPR accounts for the specificity of polypharmacy including number of medications, medication switching, duplication, overlapping. Research is needed to further confirm the validity of this new index.

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Utilization of oral antihyperglycemic drugs over a 7–year period (1998–2004) in a Hungarian population and adherence to drug therapy

Abstract: The utilization pattern of OAHDs considerably changed, but there were no significant changes in patients' adherence. The significant increase in the utilization of OAHDs is not the result of increased adherence but of increased patient number.

Cited by 32 publications

References 13 publications

Cigarette Smoking, Obesity, Physical Activity, and Alcohol Use As Predictors of Chemoprevention Adherence in the National Surgical Adjuvant Breast and Bowel Project P-1 Breast Cancer Prevention Trial

Cigarette Smoking, Obesity, Physical Activity, and Alcohol Use As Predictors of Chemoprevention Adherence in the National Surgical Adjuvant Breast and Bowel Project P-1 Breast Cancer Prevention Trial

Refill adherence by the elderly for asthma/chronic obstructive pulmonary disease drugs dispensed over a 10-year period

A method for calculating adherence to polypharmacy from dispensing data records

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