Compliance Monitoring of Nsaid Drug Therapy in Ankylosing Spondylitis, Experiences With an Electronic Monitoring Device

Klerk, E de; Linden, S.J. van der

doi:10.1093/rheumatology/35.1.60

Cited by 53 publications

(88 citation statements)

References 13 publications

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“…In our study, full adherence occurred on a median of 70% of the monitored days, which is close to the 78% full adherence found in patients with ankylosing spondylitis (the only other study using MEMS to assess NSAID adherence) (13). In contrast, full adherence as assessed by electronic monitoring has been much lower in other pediatric studies.…”

Section: Discussionsupporting

confidence: 80%

“…For example, full adherence to inhaled steroids or bronchodilator medications for children with asthma has ranged from 5 to 50% of monitored days (19,20). Days with no detectable adherence were quite low in our study, occurring on only 7% of the days, compared with 19% of the monitored days in the other NSAID study using the MEMS (13). In contrast, studies on children with asthma have reported a higher percentage of days with no adherence to inhaled medications (range 20 -48%) (19,21,22).…”

Section: Discussioncontrasting

confidence: 52%

“…To our knowledge, only 2 studies on adherence to NSAIDs have used electronic monitors. One involved patients with ankylosing spondylitis (13), and the other targeted a subset of patients in the current study who participated in an adherence intervention trial (14). The latter involved a 28-day preintervention baseline period, which is the focus of the current study.…”

Section: Introductionmentioning

confidence: 99%

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Electronically monitored adherence to medications by newly diagnosed patients with juvenile rheumatoid arthritis

Rapoff

Belmont

Lindsley

et al. 2005

Arthritis & Rheumatism

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Objective. To describe patterns of adherence to nonsteroidal antiinflammatory drugs (NSAIDs) in newly diagnosed patients with juvenile rheumatoid arthritis (JRA), and to examine demographic and disease-related variables as potential predictors of adherence. Methods. Adherence to NSAIDs was monitored in 48 children with JRA (mean age 8.6 years) over 28 consecutive days using an electronic monitoring device. Measures of disease activity (active joint counts, morning stiffness) and demographics (age, sex, ethnicity, socioeconomic status) were also obtained. Results. Using an 80% adherence cut point, 25 (52%) patients were classified as adherent and 23 (48%) as nonadherent. There was considerable variability across patients, with full adherence (taking all doses on time) ranging from 0 to 100% of the monitored days. Logistic regression showed that active joint count and socioeconomic status were the only significant predictors. Both were positively related to adherence. The model correctly classified 70.5% of patients as either adherent or nonadherent (Cox and Snell R 2 ‫؍‬ 0.295, P ‫؍‬ 0.0005). Conclusion. Children newly diagnosed with JRA are more likely to adhere to an NSAID regimen if they have a greater number of active joints or their families have higher socioeconomic status. The former finding suggests that children's adherence is symptom-driven, while the latter suggests that families of lower socioeconomic status deserve special attention to address adherence issues.

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Section: Discussionsupporting

confidence: 80%

Section: Discussioncontrasting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

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Electronically monitored adherence to medications by newly diagnosed patients with juvenile rheumatoid arthritis

Rapoff

Belmont

Lindsley

et al. 2005

Arthritis & Rheumatism

View full text Add to dashboard Cite

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“…Chronicity is associated with decreased compliance as shown in some chronic pain problems such as headache 58 , rheumatoid arthritis 59 and ankylosing spondylitis. 60 During the last decade many methods have been devised to assess compliance, but the complexity of the problem has prevented the development of a`gold standard' method of measurement. The most frequently used methods are drug levels in blood or urine as direct measures and interviews, diaries and tablet counts (e.g.…”

Section: Analgesics and Compliancementioning

confidence: 99%

“…62 Non-compliance due to fear of becoming dependent on the medication has been pointed out in populations as divergent as asthmatic patients, general practice patients taking long-term medication or patients su ering from ankylosing spondylitis. 60 Such ®ndings in rheumatoid arthritis and ankylosing spondylitis patients may lead them to consider compliance with medication intake as a last resort, when the symptoms are more unacceptable than the fears of adverse e ects and possible dependence. 63 For ADs, a fear of adverse e ects has been shown in depressive patients as well as in the general population.…”

Section: Analgesics and Compliancementioning

confidence: 99%

Advances with analgesics and NSAIDs for the treatment of spinal disorders

Desmeules

Cedraschi

Piguet

et al. 2002

Best Practice & Research Clinical Rheumatology

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One of the major developments with regard to chronic non-malignant pain in these last few years has been a better understanding of the mechanisms that act to maintain pain, while inferences about the pathophysiology have facilitated therapeutic decision-making.This chapter reviews the strength of evidence for the therapeutic e ect of pharmacological symptomatic approaches using non-steroidal anti-in¯ammatory agents, opioids and coanalgesics in acute and chronic back pain with an emphasis on the results of randomized controlled trials as well as on the need for long-term comparative trials of drug e cacy, toxicity and compliance.

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Potential utility of electronic drug compliance monitoring in measures of adverse outcomes associated with immunosuppressive agents

Feldman

Hackett

Bilker

et al. 1999

Pharmacoepidem. Drug Safe.

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Poor compliance with prescribed medications limits the effectiveness of many pharmacologic therapies and enhances their potential toxicities. Traditional methods of measuring drug‐taking behavior, including direct observation, patient self‐report, pill counts, and therapeutic drug level monitoring, all have well‐described limitations in validity and interpretability. Electronic medication event monitoring has been used to assess compliance with therapies for hypertension, glaucoma, anemia, and epilepsy, overcoming many problems of traditional approaches. However, no published reports describe the use of electronic monitoring with immunosuppressive agents, despite their increasing use for non‐life‐threatening conditions and their many dose‐dependent toxicities. Transplant recipients are thought to be at particular risk from noncompliance. Therefore, we undertook this study to assess the feasibility of electronically monitoring compliance with immunosuppressive drugs among renal allograft recipients. Twenty‐five kidney transplant patients receiving immunosuppressive medications from a single pharmacy were enrolled. Each subject received electronic monitors with their immunosuppressive serum drug refills for cyclosporine and azathioprine. Each subject returned their monitors after the first month of this 2‐month study for downloading data. The frequency distribution of interdose intervals were described. Two measures of average non‐compliance were calculated for both drugs: the proportion of monitored days that had missed doses, and the proportion of missed doses. Once daily and twice daily regimens of cyclosporine were compared. Concordance in drug compliance between the two drugs was calculated for each subject and averaged over the study population. Twenty‐two of 25 subjects missed one or more doses of cyclosporine or azathioprine. Seventeen (68%) subjects never missed four or more consecutive doses. Subjects were non‐compliant with cyclosporine on 8.7% of monitored days, and non‐compliance with azathioprine on 9.8% of monitored days. Subjects were non‐compliant with 6.8% of their cyclosporine doses and 9.8% of their azathioprine doses. Patients were compliant with both drugs on 86.6% of days and were non‐compliant with both drugs on 5.1% of days. Subjects were non‐compliant with cyclosporine during 5% and 13.2% of monitored days for once and twice daily dosing regimens, respectively. Concordance analysis demonstrated that for 91.7% of days of monitoring, compliance information was identical for both drugs. This study demonstrated the feasibility of electronic medication event monitoring among kidney transplant patients. This methodology represents an important tool for monitoring compliance of immunosuppressive agents essential to their safe and effective use, and should be considered for use in future studies of these drugs and others with substantial dose‐dependent toxicity. Copyright © 1999 John Wiley & Sons, Ltd.

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Compliance Monitoring of Nsaid Drug Therapy in Ankylosing Spondylitis, Experiences With an Electronic Monitoring Device

Cited by 53 publications

References 13 publications

Electronically monitored adherence to medications by newly diagnosed patients with juvenile rheumatoid arthritis

Electronically monitored adherence to medications by newly diagnosed patients with juvenile rheumatoid arthritis

Advances with analgesics and NSAIDs for the treatment of spinal disorders

Potential utility of electronic drug compliance monitoring in measures of adverse outcomes associated with immunosuppressive agents

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