Medication Adherence Trajectories: A Systematic Literature Review

Al-Hazami, Mai; Pontinha, V.; Patterson, Julie A.; Holdford, David A.

doi:10.18553/jmcp.2020.26.9.1138

Cited by 40 publications

(48 citation statements)

References 45 publications

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“…26 The selection of the number of trajectory groups and the appropriate shape (from first order to third order polynomial model) were decided based on the Bayesian information criterion (BIC) value and the subjective interpretability of the groups relative to one another. 44,45 The sample size threshold in each trajectory group was set to 5%. 46−48 In observational studies, unlike randomized control trials (RCTs), treatment groups tend to be systematically different from each other, and hence, can give biased treatment effect estimates due to selection bias.…”

Section: Statistical Analysesmentioning

confidence: 99%

<p>Comparative Adherence Trajectories of Oral Fingolimod and Injectable Disease Modifying Agents in Multiple Sclerosis</p>

Earla¹,

Hutton²,

Thornton³

et al. 2020

PPA

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Background Oral fingolimod is convenient to use than injectable disease modifying agents (DMAs) in patients with multiple sclerosis (MS). However, the existing literature regarding the comparative adherence trajectories between oral fingolimod and injectable DMAs is limited. Objective To compare the adherence trajectories between oral DMA, fingolimod, and injectable DMAs in patients with MS. Methods A retrospective longitudinal study was conducted using adults (≥18 years) with MS (ICD-9-CM: 340 and a DMA prescription) from the IBM MarketScan Commercial Claims and Encounters Database between 2010 and 2012. Patients were grouped into oral fingolimod or injectable DMA users based on the index DMA among patients with MS. The annual DMA adherence trajectories, based on the proportion of days covered (PDC), were examined using group-based trajectory modeling (GBTM) during the one-year follow-up period after treatment initiation. Multivariable multinomial logistic regression using stabilized inverse probability treatment weights (IPTW) was performed to assess the association between the DMA route of administration (Oral vs Injectable) and the adherence trajectory groups. The balance of covariates between oral and injectable DMAs before and after IPTW was checked against a standardized difference threshold of 0.25. Results The study cohort consisted of 1,700 MS patients who were initiated with oral (15.8%) or injectable (84.2%) DMAs between 2010 and 2012. The adherence rates (PDC≥0.8) in oral fingolimod and injectable DMA users were found to be 64.7% and 50.8%, respectively. The GBTM grouped individuals in the study cohort into three adherence trajectories – rapid discontinuers (23.5%), complete adherers (49.9%), and slow decliners (26.6%). The multinomial logistic regression model with stabilized IPTW revealed that oral fingolimod users had higher odds to be a complete adherer (adjusted odds ratio [AOR]: 2.78, 95% CI: 1.85–4.16) or a slow discontinuer (AOR: 2.62, 95% CI: 1.70–4.05) than injectable DMA users. Conclusions Oral DMA fingolimod was associated with better adherence than injectable DMAs across group-based trajectories. Further research is warranted to evaluate the adherence trajectories with newer oral DMAs introduced in the last decade for MS.

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Section: Statistical Analysesmentioning

confidence: 99%

<p>Comparative Adherence Trajectories of Oral Fingolimod and Injectable Disease Modifying Agents in Multiple Sclerosis</p>

Earla¹,

Hutton²,

Thornton³

et al. 2020

PPA

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“… 7 Given the strong association between nonadherence and visual field progression, 8 the primary goal of this study was to assess the impact of the COVID-19 pandemic on adherence to ocular hypotensive therapy in patients with POAG. Adherence—conceptualized as a dynamic process 9 —is likely to fluctuate in response to stressful situations or changes in personal circumstances. As a result, a secondary goal of this study was to identify factors associated with medication adherence during the pandemic.…”

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confidence: 99%

The Impact of the Coronavirus Disease 2019 Pandemic on Adherence to Ocular Hypotensive Medication in Patients with Primary Open-Angle Glaucoma

Racette¹,

Abu²,

Poleon³

et al. 2022

Ophthalmology

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Objective Emerging evidence suggests that the COVID-19 pandemic is disrupting health behaviors such as medication adherence. The objective of this study was to determine whether adherence to ocular hypotensive medication was affected by the pandemic and to identify factors associated with this change. Design In this cohort study, we used a controlled interrupted time series design in which the interruption was the declaration of the COVID-19 pandemic in the United States on March 13, 2020. The 300-day monitoring period, which evenly bracketed this declaration, started on October 16, 2019, and ended on August 10, 2020. Participants Patients with primary open-angle glaucoma enrolled in an ongoing longitudinal NIH-funded study initiated prior to the onset of the pandemic were selected if they were prescribed ocular hypotensive medication and had adherence data spanning the 300-day period. Methods We applied segmented regression analysis using a “slope change following a lag” impact model to obtain the adherence slopes in the periods preceding and following the segmentation. We compared the two slopes using the Davies test. Main outcome and measure The main outcome measure was daily adherence to ocular hypotensive medication—defined as the number of doses taken divided by the number of doses prescribed, expressed in percent. Adherence was measured objectively using Medication Event Monitoring System (MEMS) caps. We assessed the associations between change in adherence and demographic, clinical, and psychosocial factors. Results The sample included 79 patients (mean age, 71 years [SD, 8 years]). Segmented regression identified a breakpoint at day 28 following the declaration of the pandemic. The slope in the post-breakpoint period (-0.04%/day) was significantly different from zero ( P < 0.001) and from the slope in the period preceding the breakpoint (0.006%/day) ( P < 0.001). A significant positive association was observed between the Connor-Davidson Resilience score and the change in slope between the pre- and post-breakpoint periods ( P = 0.002). Conclusions and Relevance Adherence to ocular hypotensive medication worsened during the COVID-19 pandemic and appears to be related to patient resilience. This collateral consequence of the pandemic may translate into vision loss that may manifest beyond its containment.

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“…[17] The method and its applications, the macroimplementations in the software, are well established and developed in many disciplines, such as pharmacoepidemiology. [42] Most of the studies on GBTM in this eld have primarily used trajectories to describe membership groups over time and associated factors. [43,44] To our knowledge, there are two systematic reviews on Latent Class Modelling approaches, including the GBTM method.…”

Section: Discussionmentioning

confidence: 99%

Group-Based Trajectory Modelling (GBTM) To Assess the Effect of Medication Adherence on Health-Related Outcomes: A Protocol for A Systematic Review

Memoli

Ekanmian

Lunghi

et al. 2021

Preprint

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Background: The Group-based trajectory modelling (GBTM) method is increasingly used in pharmacoepidemiologic studies to describe medication adherence trajectories over time. However, assessing the effects of these medication adherence trajectories on health-related outcomes remains challenging. The purpose of this review is to describe studies assessing the effects of medication adherence trajectories estimated by the GBTM method on health-related outcomes. Methods: We will conduct a systematic review according to the recommendations of the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. We will search in the following databases: PubMed, Embase, PsycINFO, Web of Science, CINAHL, and Cochrane database up to April 1st, 2021. Two reviewers will independently select articles and extract data. Discrepancies at every step will be resolved through discussion, and consensus will be reached for all disagreed articles. A third reviewer will act as a referee if needed. We will use tables to synthesize the modalities used to estimate medication adherence trajectories and the effect of adherence trajectories on health-related outcomes. We will identify the types of health-related outcomes studied and how they are defined, the statistical models used, the effect measure yield, and how medication adherence trajectories have been incorporated in the model. We will also review the limitations and biases reported by the authors and their attempts to mitigate them. We will provide a narrative synthesis.Discussion: This review will provide a clear view of the strategies and methods used in medication adherence research to estimate the effects of adherence trajectories on different health-related outcomes. A thorough exploration of how GBTM is used for this specific purpose could represent the first crucial steps towards optimizing the utilization of this method in adherence studies. Systematic review registration: Prospero CRD42021213503.

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Medication Adherence Trajectories: A Systematic Literature Review

Cited by 40 publications

References 45 publications

<p>Comparative Adherence Trajectories of Oral Fingolimod and Injectable Disease Modifying Agents in Multiple Sclerosis</p>

<p>Comparative Adherence Trajectories of Oral Fingolimod and Injectable Disease Modifying Agents in Multiple Sclerosis</p>

The Impact of the Coronavirus Disease 2019 Pandemic on Adherence to Ocular Hypotensive Medication in Patients with Primary Open-Angle Glaucoma

Group-Based Trajectory Modelling (GBTM) To Assess the Effect of Medication Adherence on Health-Related Outcomes: A Protocol for A Systematic Review

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