Adherence to raloxifene therapy: assessment methods and relationship with efficacy

Finigan, J.; Naylor, Kim; Paggiosi, Margaret; Peel, Nicola; Eastell, Richard

doi:10.1007/s00198-013-2386-6

Cited by 9 publications

(7 citation statements)

References 27 publications

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“…The characteristics of the studies included are reported in Table . Sixty‐three (54%) studies were conducted in North America and 35 (30%) in Europe . A few studies were conducted in Africa ( n = 10) , Asia ( n = 6) , South America ( n = 2) or Australia ( n = 1) .…”

Section: Resultsmentioning

confidence: 99%

“…Of note, when a continuous outcome was used, a correlation approach was considered in 36 comparisons to assess agreement between measurement methods leading to an average correlation of 0.35, ranging from À0.67 to 0.76 [5,8,16,19,24,29,33,34,41,43,55,62,63,65,67,69,86,88,90,91]. For 31 of those correlations, the null hypothesis of no correlation was formally tested and rejected (P < 0.05) in 24 cases (77%) leading to the conclusion that there is a significant linear association between the measurement methods.…”

Section: Analysis Of Extracted Datamentioning

confidence: 99%

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A scoping review of studies comparing the medication event monitoring system (MEMS) with alternative methods for measuring medication adherence

Alili

Vrijens

Demonceau

et al. 2016

Brit J Clinical Pharma

149

100

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Different methods are available for measuring medication adherence. In this paper, we conducted a scoping review to identify and summarize evidence of all studies comparing the Medication Event Monitoring System (MEMS) with alternative methods for measuring medication adherence. A literature search was performed using the open database www.iAdherence.org that includes all original studies reporting findings from the MEMS. Papers comparing methods for measuring adherence to solid oral formulations were included. Data was extracted using a standardized extraction table. A total of 117 articles fulfilled the inclusion criteria, including 251 comparisons. Most frequent comparisons were against self-report (n = 119) and pill count (n = 59). Similar outcome measures were used in 210 comparisons (84%), among which 78 used dichotomous variables (adherent or not) and 132 used continuous measures (adherence expressed as percentage). Furthermore, 32% of all comparisons did not estimate adherence over the same coverage period and 44% of all comparisons did not use a statistical method or used a suboptimal one. Only eighty-seven (35%) comparisons had similar coverage periods, similar outcome measures and optimal statistical methods. Compared to MEMS, median adherence was grossly overestimated by 17% using self-report, by 8% using pill count and by 6% using rating. In conclusion, among all comparisons of MEMS versus alternative methods for measuring adherence, only a few used adequate comparisons in terms of outcome measures, coverage periods and statistical method. Researchers should therefore use stronger methodological frameworks when comparing measurement methods and be aware that non-electronic measures could lead to overestimation of medication adherence.

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Section: Resultsmentioning

confidence: 99%

Section: Analysis Of Extracted Datamentioning

confidence: 99%

A scoping review of studies comparing the medication event monitoring system (MEMS) with alternative methods for measuring medication adherence

Alili

Vrijens

Demonceau

et al. 2016

Brit J Clinical Pharma

149

100

View full text Add to dashboard Cite

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“…Tablet count was defined as the number of tablets taken (not present in the container) expressed as the percentage of the correct number of tablets advised by the physician for the study period, that is, 90 tablets. 24 , 25 …”

Section: Methodsmentioning

confidence: 99%

Drug holidays: the most frequent type of noncompliance with calcium plus vitamin D supplementation in persistent patients with osteoporosis

Touskova¹,

Vytrisalova²,

Palička³

et al. 2015

PPA

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PurposeAll current recommendations include calcium and vitamin D (Ca–D) as an integrated part of osteoporosis treatment. The purpose of this pilot study was to analyze compliance with a fixed combination of Ca–D in women persistent with the treatment.Patients and methodsAn observational study was carried out in three osteocenters in the Czech Republic. Women with osteoporosis ≥55 years of age concurrently treated with oral ibandronate were eligible. Compliance was evaluated in a period of 3 months by Medication Event Monitoring System (MEMS), tablet count, and self-report. Nonpersistence was defined as a MEMS-based gap in the use of Ca–D to be 30 days or more.ResultsA total of 73 patients were monitored, of which 49 patients were analyzed (target population). Based on MEMS, mean overall compliance was 71%; good compliance (≥80%) was observed in 59% of the patients. As many as 71% of the patients took drug holidays (≥3 consecutive days without intake); overall compliance of these patients was 59% and was slightly lower on Fridays and weekends. Patients without drug holidays were fully compliant (did not omit individual doses). Compliance differed according to daily time at which the patients mostly used the Ca–D. Afternoon/evening takers showed a mean overall compliance of 82% while morning/night takers only 51% (P=0.049). Based on MEMS, tablet count, and self-report, compliance ≥75% was observed in 59%, 100%, and 87% of the patients, respectively. Outcomes obtained by the three methods were not associated with each other. Undesirable concurrent ingestion of Ca–D and ibandronate was present only twice.ConclusionDespite almost perfect self-reported and tablet count-based compliance, MEMS-based compliance was relatively poor. Consecutive supplementation-free days were common; more than two-thirds of the patients took at least one drug holiday. This pilot study showed drug holiday to be the most important type of noncompliance with Ca–D in those who are persistent with the treatment.

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“…Adherence was assessed using medical events monitoring system (MEMS) bottle caps (AARDEX, Zurich, Switzerland), which record the date and number of times a medication bottle is opened [22] . Complete MEMS data were available for 17 of the 21 women, 12 women had compliance >80% and 5 women >60%.…”

Section: Study Interventionmentioning

confidence: 99%

“…Changes in bone markers in response to treatment occur earlier and are of a greater magnitude than changes in bone density. A significant change in BMD can rarely be detected in an individual in response to oral anti-resorptive therapy in less than [18][19][20][21][22][23][24] months. Compliance with treatment is a concern in clinical practice and monitoring patients on treatment using biochemical markers can provide useful additional information for the management of patient care [14] .…”

Section: Introductionmentioning

confidence: 99%

Response of bone turnover markers to raloxifene treatment in postmenopausal women with osteopenia

et al. 2016

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Introduction: The change in bone turnover markers (BTM) in response to osteoporosis therapy can be assessed by a decrease beyond the least significant change (LSC) or below the mean of the reference interval (RI). We compared the performance of these two approaches in women treated with raloxifene.Methods: Fifty postmenopausal osteopenic women, (age 51-72y) were randomised to raloxifene or no treatment for 2 years. Blood samples were collected for the measurement of BTM. The LSC for each marker was calculated from the untreated women and the RI obtained from healthy premenopausal women (age 35-40y). Bone mineral density (BMD) was measured at the spine and hip.Results: There was a decrease in BTM in response to raloxifene treatment; percentage change at 12 weeks, CTX -39% (95% CI -48 to -28) and PINP -32% (95% CI -40 to -23) P<0.001. The proportion of women classified as responding to treatment using LSC at 12 weeks was: CTX 38%, PINP 52%, at 48 weeks CTX 60%, PINP 65%. For the RI approach; at 12 weeks CTX and PINP 38%, at 48 weeks CTX 40%, PINP 45%. There was a significant difference in the change in spine BMD in the raloxifene treated group compared to the no-treatment group at week 48; difference 0.031 g/cm2, (95% CI 0.016 to 0.046, P<0.001).Conclusions: The two approaches identified women that reached the target for treatment using BTM.Both LSC and RI criteria appear useful in identifying treatment response but the two approaches do not fully overlap and may be complementary.

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Adherence to raloxifene therapy: assessment methods and relationship with efficacy

Cited by 9 publications

References 27 publications

A scoping review of studies comparing the medication event monitoring system (MEMS) with alternative methods for measuring medication adherence

A scoping review of studies comparing the medication event monitoring system (MEMS) with alternative methods for measuring medication adherence

Drug holidays: the most frequent type of noncompliance with calcium plus vitamin D supplementation in persistent patients with osteoporosis

Response of bone turnover markers to raloxifene treatment in postmenopausal women with osteopenia

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