Evaluation of adherence to antipsychotics: A real-world data study using four different dosing assumptions
Por:
Fuente M, Dima AL, Rubio-Valera M, Baladon L, Chavarría V, Fabrizio S, Peña C, Serra-Sutton V, Hermida-González P, de Loño JP, Rey-Abella ME, Aznar I and Serrano-Blanco A
Publicada:
1 jun 2024
Ahead of Print:
1 mar 2024
Resumen:
AimsThis study aimed to assess the frequency of dosing inconsistencies in prescription data and the effect of four dosing assumption strategies on adherence estimates for antipsychotic treatment.MethodsA retrospective cohort, which linked prescription and dispensing data of adult patients with >= 1 antipsychotic prescription between 2015-2016 and followed up until 2019, in Catalonia (Spain). Four strategies were proposed for selecting the recommended dosing in overlapping prescription periods for the same patient and antipsychotic drug: (i) the minimum dosing prescribed; (ii) the dose corresponding to the latest prescription issued; (iii) the highest dosing prescribed; and (iv) all doses included in the overlapped period. For each strategy, one treatment episode per patient was selected, and the Continuous Medication Availability measure was used to assess adherence. Descriptive statistics were used to describe results by strategy.ResultsOf the 277 324 prescriptions included, 76% overlapped with other prescriptions (40% with different recommended dosing instructions). The number and characteristics of patients and treatment episodes (18 292, 18 303, 18 339 and 18 536, respectively per strategy) were similar across strategies. Mean adherence was similar between strategies, ranging from 57 to 60%. However, the proportion of patients with adherence >= 90% was lower when selecting all doses (28%) compared with the other strategies (35%).ConclusionDespite the high prevalence of overlapping prescriptions, the strategies proposed did not show a major effect on the adherence estimates for antipsychotic treatment. Taking into consideration the particularities of antipsychotic prescription practices, selecting the highest dose in the overlapped period seemed to provide a more accurate adherence estimate.
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Filiaciones:
Fuente M:
Health Technology Assessment in Primary Care and Mental Health (PRISMA) Research Group, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
Dima AL:
Health Technology Assessment in Primary Care and Mental Health (PRISMA) Research Group, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
Rubio-Valera M:
Health Technology Assessment in Primary Care and Mental Health (PRISMA) Research Group, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
Baladon L:
Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
Chavarría V:
Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
Fabrizio S:
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
Peña C:
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS)
Health Quality and Assessment Agency of Catalonia, Barcelona, Spain
Serra-Sutton V:
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
Unitat de Farmàcia. Regió Sanitària Metropolitana Sud CatSalut, Barcelona, Spain
Hermida-González P:
Unitat de Farmàcia. Regió Sanitària Metropolitana Sud CatSalut, Barcelona, Spain
de Loño JP:
Unitat de Farmàcia. Regió Sanitària Metropolitana Sud CatSalut, Barcelona, Spain
Rey-Abella ME:
Unitat de Farmàcia. Regió Sanitària Metropolitana Sud CatSalut, Barcelona, Spain
Aznar I:
Health Technology Assessment in Primary Care and Mental Health (PRISMA) Research Group, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
Serrano-Blanco A:
Health Technology Assessment in Primary Care and Mental Health (PRISMA) Research Group, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
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