Não adesão à terapia biológica em pacientes com doenças reumáticas no Sistema Único de Saúde em Minas Gerais, Brasil

Dabés, Clarice Gomes e Souza; Almeida, Alessandra Maciel; Acúrcio, Francisco de Assis

doi:10.1590/0102-311x00169514

Cited by 6 publications

(5 citation statements)

References 30 publications

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“…Patients with PDC ≥0.8 were classified as adherent to the anti-TNF drug since this value has been adopted as a cutoff point for rheumatic diseases. 32 , 33 …”

Section: Methodsmentioning

confidence: 99%

Medication adherence and persistence of psoriatic arthritis patients treated with biological therapy in a specialty pharmacy in Brazil: a prospective observational study

Souza¹,

Silva²,

Santos³

et al. 2021

Pharm Pract (Granada)

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Background: Pharmaceutical services in Brazil provide access, supply, and rational use of drugs for all population and an effort has been made to improve the quality of these services. Biological drugs are high-cost drugs supplied in Brazil that can inhibit disease progression and improve the quality of life of psoriatic arthritis (PsA) patients. However, some patients did not achieve therapeutic goals. Objective: To evaluate the medication adherence and persistence of PsA patients treated with tumor necrosis factor inhibitors (anti-TNF) drugs and their associated factors. Methods: A prospective observational study was performed at a single-specialty pharmacy in Belo Horizonte, Brazil. Medication adherence, persistence, and clinical outcomes were evaluated at 12 months of follow-up. Medication persistence was historically compared to overall PsA patients treated in Brazil. Associated factors were identified through log-binomial regression. Results: One hundred ninety-seven PsA patients were included in the study, of whom 147 (74.6%) and 142 (72.1%) had medication adherence and persistence, respectively. Patients treated with infliximab presented the highest adherence (90.5%) and persistence rate (95.2%) in comparison to patients treated with other drugs, except for adalimumab versus infliximab for adherence outcome. All clinical measures significantly improved in patients with medication adherence and persistence. Medication persistence was higher for patients attended by specialty pharmacy than other PsA patients in Brazil. The associated factors to higher medication adherence were lower disease activity by BASDAI, being non-white race, and intravenous drug use. The associated factors to higher medication persistence were lower disease activity by Bath Ankylosing Spondylitis Activity Index (BASDAI), intravenous drug use, non-use of corticoids and non-steroidal anti-inflammatory drugs, and comorbidity. Conclusions: Patients with medication adherence and persistence had significant improvements in clinical measures, functionality, and quality of life. High medication adherence and persistence to biological therapy were observed and associated with lesser disease activity at baseline. Also, medication persistence to PsA patients attended in specialty pharmacy was higher than the overall PsA population in Brazil, which indicates the importance of pharmaceutical services to provide health care and promote the effectiveness and safety of biological therapies.

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“…Patients with PDC ≥0.8 were classified as adherent to the anti-TNF drug since this value has been adopted as a cutoff point for rheumatic diseases. 32 , 33 …”

Section: Methodsmentioning

confidence: 99%

Medication adherence and persistence of psoriatic arthritis patients treated with biological therapy in a specialty pharmacy in Brazil: a prospective observational study

Souza¹,

Silva²,

Santos³

et al. 2021

Pharm Pract (Granada)

View full text Add to dashboard Cite

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“…Cardoso & Galera 17 and Fonseca et al 20 the time interval recorded between dispensing episodes for analysis of the use of medications and treatment dropout, respectively. A more recent study, on biological therapy in rheumatic diseases, specified the use of the PDC indicator to identify patients without adherence to treatment 21 . Other studies from Brazil and elsewhere have focused on persistence as the outcome measure for use of indicators based on pharmacy records, which suggests evolution in adherence concepts as the result of dosing history 56,95,100,112 .…”

Section: Discussionmentioning

confidence: 99%

“…Considering the limited availability of clinical and prescription records, many studies are limited to national or local information systems with records on the supply and dispensing of medications 12,13,14,15 . These records have been used to construct indicators for the analysis of adherence and its determinants 12,16,17,18,19,20,21,22 .…”

mentioning

confidence: 99%

Utilização de registros de dispensação de medicamentos na mensuração da adesão: revisão crítica da literatura

et al. 2017

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The current frame of reference on adherence to pharmacotherapy includes a set of behaviors experienced by the user, with observation of the detailed and continuous history of the use of each dose of the medication. Indicators based on pharmacy records have been used to measure adherence. The current review aimed to identify and describe indicators based on pharmacy records and to discuss their adequacy and limitations for measuring adherence. An exploratory literature review was conducted in three databases using the terms "adherence", "pharmacy records/administrative data", and "measure" to compose the descriptors for the selection of 81 articles and the elaboration of a chart with the denomination, sources, methods for calculation, description, and interpretation of the operational and referential meaning of 14 indicators. Given the most recent taxonomy for adherence proposed in the literature, we concluded that the indicators can be useful for identifying patients with medication-seeking behavior-related problems and analysis of persistence. The distance between supply-related events and difficulties in treatment follow-up can influence an analysis based exclusively on the use of these indicators.

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“…The value of PDC ≥90 was adopted in studies that used data from dispensation to assess adherence in patients with MM and other chronic diseases, such as chronic myeloid leukemia and rheumatoid arthritis. 8,13,20…”

Section: Methodsmentioning

confidence: 99%

“…The value of PDC 90 was adopted in studies that used data from dispensation to assess adherence in patients with MM and other chronic diseases, such as chronic myeloid leukemia and rheumatoid arthritis. 8,13,20 Sociodemographic, clinical, care, and pharmacotherapeutic variables. Age and gender data were obtained through IPCMS.…”

Section: Variables and Data Collectionmentioning

confidence: 99%

Adherence to thalidomide in patients with multiple myeloma: A cross-sectional study in a Brazilian metropolis

Silveira

Pádua

Drummond

et al. 2021

J Oncol Pharm Pract

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Purpose The treatment of multiple myeloma (MM) has advanced with the introduction of immunomodulators (IMiDS). Thalidomide is the IMiD available in Brazil with free access to MM patients. Adherence to treatment with IMiDs is essential for a successful therapy. The study proposed to describe adherence to thalidomide treatment in patients diagnosed with MM in onco-hematological outpatient clinics. Methods This is a cross-sectional study with patients over 18 years of age diagnosed with MM undergoing thalidomide treatment. Adherence was measured by the Proportion of Days Covered (PDC), which is an indirect method of measuring adherence that uses database-related medication dispensing information. Patients with PDC ≥90 were classified as adherent. The association between adherence and independent variables was assessed in univariate and multivariate analyses using logistic regression. Results A total of 65 patients with a median age of 62.6 years were identified. The median PDC was 93.7%. The frequency of adherence to thalidomide was 56.9%. Adherence to thalidomide showed a negative association with hospitalization in the last 12 months (OR = 0.202; 95% CI = 0.060–0.687) and with higher schooling (OR =0.161; 95% CI = 0.039–0.667) and a positive association with higher income (OR = 5.115; 95% CI = 1.363–19.190). Conclusion Most patients from onco-hematological outpatient clinics in a metropolitan region of southeastern Brazil showed high adherence to thalidomide, which was independently associated with higher income, hospitalization, and higher schooling. More studies are required to understand better the determinants of adherence to thalidomide in the country.

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Não adesão à terapia biológica em pacientes com doenças reumáticas no Sistema Único de Saúde em Minas Gerais, Brasil

Cited by 6 publications

References 30 publications

Medication adherence and persistence of psoriatic arthritis patients treated with biological therapy in a specialty pharmacy in Brazil: a prospective observational study

Medication adherence and persistence of psoriatic arthritis patients treated with biological therapy in a specialty pharmacy in Brazil: a prospective observational study

Utilização de registros de dispensação de medicamentos na mensuração da adesão: revisão crítica da literatura

Adherence to thalidomide in patients with multiple myeloma: A cross-sectional study in a Brazilian metropolis

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