Clinical Value of Emerging Bioanalytical Methods for Drug Measurements: A Scoping Review of Their Applicability for Medication Adherence and Therapeutic Drug Monitoring

Zijp, Tanja R; Izzah, Zamrotul; Åberg, Christoffer; Gan, C. Tji-Joong; Bakker, Stephan J. L.; Touw, Daan; Boven, Job F.M. van

doi:10.1007/s40265-021-01618-7

Cited by 20 publications

(15 citation statements)

References 112 publications

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Section: Discussionmentioning

confidence: 99%

“…Data exist that openings are a good proxy for drug intake, 36 but "true" pill ingestion measurement may only be possible by more complex or invasive methods, such as directly observed therapy, using digital pills, or measuring drug concentrations in body fluids or tissue. 20,[37][38][39] Medication event recording devices could improve adherence in patient-centered care, providing subjects with feedback in terms of a graphical display of adherence performance. 14 The performance records could enable healthcare professionals to tailor interventions based on subject's individual adherence patterns.…”

Section: Discussionmentioning

confidence: 99%

“…34 As the adherence measurement methods used in this study are not able to objectively confirm real drug intake, biochemical drug measurements are recommended to further validate adherence data, preferably through non-invasive methods. 39 When deemed sufficiently validated, the use of smart blister packages may be further scaled-up in clinical trials as well as daily practice. In real medication studies, the adherence data could be used to interpret clinical outcomes or pharmacokinetics.…”

Section: Future Perspectivesmentioning

confidence: 99%

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Electronic Smart Blister Packages to Monitor and Support Medication Adherence: A Usability Study

Izzah¹,

Zijp²,

Åberg³

et al. 2022

PPA

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Purpose An electronic version of the Dosepak ® (EDP) which records date and time of dosing events has been developed to monitor adherence to medication packaged in blisters. This study aimed to evaluate its usability and acceptance and to monitor dose-taking adherence for optimal implementation in future clinical trials and practice. Methods Healthy volunteers aged over 18 years were asked to dispense placebo tablets twice daily from EDPs equipped with a re-usable electronic module for a total duration of four weeks. Afterwards, subjects were asked to complete an online questionnaire and partake in a short one-on-one interview. The usability of the EDP was assessed using the System Usability Scale (SUS), while dose-taking adherence was monitored by EDP records, pill counting, and self-report. The short interview explored user experiences in more detail. Results Twenty subjects with median [IQR] age 41.5 [32–49.8] years, 55% female, 45% healthcare professionals, and 20% chronic medication users completed the study and found the EDP easy to use, with a mean [SD] SUS score of 78.0 [11.2]. Median [IQR] dose-taking adherence was 89% [82–95%] based on EDP records, 96.5% [89–100%] based on pill counting, 92% [91–96%] based on self-report, and the levels differed significantly (p < 0.05). Four themes emerged from the interviews: user preference, experience, patient burden, and ideas for improvement. Most participants preferred smaller sized blisters. They found the EDP simple to use and did not see any patient burden for its use in trials or clinical practice. Some reported forgetfulness and suggested reminders built into the blister or sent to their mobile phones. Adequate information or instruction should also be provided for older people and polypharmacy patients. Conclusion EDP had good perceived usability, was well accepted, and differed significantly from other adherence measurement methods. This study provides input to further guide scale-up of the blister packages.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Future Perspectivesmentioning

confidence: 99%

See 1 more Smart Citation

Electronic Smart Blister Packages to Monitor and Support Medication Adherence: A Usability Study

Izzah¹,

Zijp²,

Åberg³

et al. 2022

PPA

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“…One recent trial including paediatric lung transplant recipients found a reduction in the Tac IPV at 6 months in 10 patients undergoing 3-weekly phone calls and regular follow-up calls (Tac SD −1.84; 95% CI: −2.95, −0.74; P = 0.004) compared with 7 controls undergoing only regular follow-up calls (Tac SD 0.59; 95% CI: −1.42, 2.60; P = 0.46) [ 73 ]. Telemedicine may be integrated with home-based dried blood spots (DBS) sampling of Tac for the purpose of therapeutic drug monitoring [ 74 , 75 ]. The use of remote monitoring and telemedicine can improve patient quality of life and independence [ 60 ], limiting the patients’ psychological distress, but its role in everyday clinical practice needs further validation.…”

Section: General Interventions For Mna Prevention and Treatmentmentioning

confidence: 99%

Detecting, preventing and treating non-adherence to immunosuppression after kidney transplantation

Gandolfini

Palmisano

Fiaccadori

et al. 2022

Clinical Kidney Journal

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Medication non-adherence (MNA) is a major issue in kidney transplantation and it is associated with increased risk of rejection, allograft loss, patients’ death, and higher healthcare costs. Despite its crucial importance, it is still unclear what are the best strategies to diagnose, prevent, and treat MNA. MNA can be intentional (deliberate refusal of adhere to a prescribed medication) or unintentional (non-deliberate missing the prescribed medication). Its diagnosis may rely on direct methods, aiming at measuring drug ingestions, or indirect methods, which analyze the habits of patients to check their adherence to correct drug dose (taking adherence) and intervals (time adherence). Identifying individual risk factors for MNA may provide the basis for a personalized approach to the treatment of MNA. Randomized control trials performed so far tested a combination of strategies, such as enhancing medication adherence through the involvement of healthcare personnel involved in drug distribution, the use of electronic reminders, therapy simplification, or various multidisciplinary approaches to maximize the correction of individual risk factors. Although most of these approaches reduced MNA in the short-term, the long-term effects on MNA, and, more importantly, on clinical outcomes remain unclear. In this review, we provide a critical appraisal of traditional and newer methods for detecting, preventing, and treating non-adherence to immunosuppression after kidney transplantation from the perspective of the practicing physician.

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“…Currently, our arsenal for practicing precision drug therapy is expanding and already includes different emerging biomarkers such as FeNO and blood eosinophils ( 14 ) and exploration of the microbiome ( 15 ). Another option is therapeutic drug monitoring where drug concentrations are measured in body fluids (e.g., blood, sputum, urine) and used to adjust individual drug dosing accordingly ( 16 , 17 ). Other developments include electronic inhalers that may help to further understand individual dosing patterns ( 18 ) and inform the subsequent provision of personalized medication adherence support ( 19 ) and follow-up treatment.…”

mentioning

confidence: 99%

Towards precision drug therapy in asthma

Boven¹

2022

Ann Transl Med

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Clinical Value of Emerging Bioanalytical Methods for Drug Measurements: A Scoping Review of Their Applicability for Medication Adherence and Therapeutic Drug Monitoring

Cited by 20 publications

References 112 publications

Electronic Smart Blister Packages to Monitor and Support Medication Adherence: A Usability Study

Electronic Smart Blister Packages to Monitor and Support Medication Adherence: A Usability Study

Detecting, preventing and treating non-adherence to immunosuppression after kidney transplantation

Towards precision drug therapy in asthma

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