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Adherence and barriers to H. pylori treatment in Arctic Canada.

https://arctichealth.org/en/permalink/ahliterature105338
Source
Int J Circumpolar Health. 2013;72:22791
Publication Type
Article
Date
2013
Author
Megan Lefebvre
Hsiu-Ju Chang
Amy Morse
Sander Veldhuyzen van Zanten
Karen Jean Goodman
Author Affiliation
Department of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada.
Source
Int J Circumpolar Health. 2013;72:22791
Date
2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Anti-Bacterial Agents - administration & dosage - adverse effects - therapeutic use
Arctic Regions - epidemiology
Canada - epidemiology
Drug Therapy, Combination
Female
Helicobacter Infections - drug therapy - ethnology
Humans
Indians, North American - statistics & numerical data
Interviews as Topic
Inuits - statistics & numerical data
Male
Medication Adherence - statistics & numerical data
Middle Aged
Proton Pump Inhibitors - administration & dosage - adverse effects - therapeutic use
Sex Distribution
Young Adult
Abstract
Helicobacter pylori infection is an emerging health concern to some northern Canadian Aboriginal communities and their clinicians. Clinicians in the north perceive H. pylori infection to be a major clinical problem because they find H. pylori infection in many patients evaluated for common stomach complaints, leading to frequent demand for treatment, which often fails. Moreover, public health authorities identified the need for information to develop locally appropriate H. pylori control strategies. We described adherence and identified barriers to completing treatment among H. pylori-positive participants in a community-based project inspired by local concerns about H. pylori infection risks.
In 2008, 110 H. pylori-positive participants (diagnosed by a breath test, histopathology and/or culture) of the Aklavik H. pylori project were randomised to standard-of-care or sequential treatment. We ascertained adherence by interviewing participants using a structured questionnaire. We estimated adherence frequencies as the proportion of participants who reported taking either 100% of doses (perfect adherence) or =80% of doses (good adherence). To compare the proportion with perfect or good adherence in subgroups, we report proportion differences and 95% confidence intervals (CI).
Of 87 participants who were interviewed, 64% reported perfect adherence and 80% reported good adherence. We observed more frequent perfect adherence for: standard therapy (67%) versus sequential (62%); males (76%) versus females (52%); participants 40-77 years (79%) versus 17-39 (50%). Proportion differences were 5% (CI: -15, 25) for standard versus sequential therapy; 23% (CI: 4, 43) for male versus female; and 29% (CI: 10, 48) for 40-77 versus 15-39 years for perfect adherence. Of the 29 participants who reported poor adherence (
Notes
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PubMed ID
24416723 View in PubMed
Less detail

Adherence and discontinuation of adjuvant hormonal therapy in breast cancer patients: a population-based study.

https://arctichealth.org/en/permalink/ahliterature127527
Source
Breast Cancer Res Treat. 2012 May;133(1):367-73
Publication Type
Article
Date
May-2012
Author
Annette Wigertz
Johan Ahlgren
Marit Holmqvist
Tommy Fornander
Jan Adolfsson
Henrik Lindman
Leif Bergkvist
Mats Lambe
Author Affiliation
Regional Cancer Centre, Uppsala University Hospital, 751 85 Uppsala, Sweden. Annette.Wigertz@akademiska.se
Source
Breast Cancer Res Treat. 2012 May;133(1):367-73
Date
May-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Antineoplastic Agents, Hormonal - therapeutic use
Aromatase Inhibitors - therapeutic use
Breast Neoplasms - prevention & control
Chemotherapy, Adjuvant
Female
Humans
Logistic Models
Maintenance Chemotherapy
Medication Adherence - statistics & numerical data
Middle Aged
Multivariate Analysis
Neoplasm Recurrence, Local - prevention & control
Neoplasms, Hormone-Dependent - prevention & control
Sweden
Tamoxifen - therapeutic use
Abstract
Adherence to long-term pharmacological treatment for chronic conditions is often less than optimal. Till date, a limited number of population-based studies have assessed adherence to adjuvant hormonal therapy in breast cancer, a therapy with proven benefits in terms of reductions of recurrence and mortality. We aimed to examine rates of adherence and early discontinuation in Sweden where prescribed medications are subsidized for all residents and made available at reduced out-of-pocket costs. Individual-level data were obtained from Regional Clinical Quality Breast Cancer Registers, the Swedish Prescribed Drug Register, and several other population-based registers. Multivariate logistic regression was used to analyze factors associated with adherence to prescribed medication for a period of 3 years. Between January 1 and December 31, 2005, 1,741 patients in central Sweden were identified with estrogen receptor positive breast cancer, and at least one prescription dispensation of either tamoxifen or an aromatase inhibitor. Of these women, 1,193 (69%) were fully adherent to therapy for 3 years (medication possession ratio of 80% or higher and a maximum of 180 days between refills). During the 3-year follow-up, 215 women (12%) had prematurely discontinued therapy. Adherence was positively associated with younger age, large tumor size, being married, and being born in the Nordic countries, while no clear association was observed with education or income. During the 3 years of follow-up, 31% of women were non-adherent to therapy. Further efforts must be undertaken to promote adherence over the entire recommended treatment period.
PubMed ID
22286315 View in PubMed
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Adherence and medication belief in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension: A nationwide population-based cohort survey.

https://arctichealth.org/en/permalink/ahliterature296214
Source
Clin Respir J. 2018 Jun; 12(6):2029-2035
Publication Type
Journal Article
Multicenter Study
Date
Jun-2018
Author
Bodil Ivarsson
Roger Hesselstrand
Göran Rådegran
Barbro Kjellström
Author Affiliation
Department of Cardiothoracic Surgery, Skåne University Hospital, Lund, Sweden.
Source
Clin Respir J. 2018 Jun; 12(6):2029-2035
Date
Jun-2018
Language
English
Publication Type
Journal Article
Multicenter Study
Keywords
Aged
Antihypertensive Agents - therapeutic use
Attitude to Health
Chronic Disease
Cross-Sectional Studies
Female
Fibrinolytic Agents - therapeutic use
Humans
Hypertension, Pulmonary - drug therapy - epidemiology - etiology
Male
Medication Adherence
Morbidity - trends
Population Surveillance
Prognosis
Pulmonary Embolism - complications - drug therapy - epidemiology
Self Report
Surveys and Questionnaires
Sweden - epidemiology
Abstract
Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are rare diseases with a gradual decline in physical health. Adherence to treatment is crucial in these very symptomatic and life threatening diseases.
To describe PAH and CTEPH patients experience of their self-reported medication adherence, beliefs about medicines and information about treatment.
A quantitative, descriptive, national cohort survey that included adult patients from all PAH-centres in Sweden. All patients received questionnaires by mail: The Morisky Medication Adherence Scale (MMAS-8) assesses treatment-related attitudes and behaviour problems, the Beliefs about Medicines Questionnaire-Specific scale (BMQ-S) assesses the patient's perception of drug intake and the QLQ-INFO25 multi-item scale about medical treatment information.
The response rate was 74% (n?=?325), mean age 66?±?14 years, 58% were female and 69% were diagnosed with PAH and 31% with CTEPH. Time from diagnosis was 4.7?±?4.2 years. More than half of the patients (57%) reported a high level of adherence. There was no difference in the patients' beliefs of the necessity of the medications to control their illness when comparing those with high, medium or low adherence. Despite high satisfaction with the information, concerns about potential adverse effects of taking the medication were significantly related to adherence.
Treatment adherence is relatively high but still needs improvement. The multi-disciplinary PAH team should, together with the patient, seek strategies to improve adherence and prevent concern.
PubMed ID
29356440 View in PubMed
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Adherence and persistence with oral adjuvant chemotherapy in older women with early-stage breast cancer in CALGB 49907: adherence companion study 60104.

https://arctichealth.org/en/permalink/ahliterature144428
Source
J Clin Oncol. 2010 May 10;28(14):2418-22
Publication Type
Article
Date
May-10-2010
Author
Ann H Partridge
Laura Archer
Alice B Kornblith
Julie Gralow
Debjani Grenier
Edith Perez
Antonio C Wolff
Xiaofei Wang
Helen Kastrissios
Donald Berry
Clifford Hudis
Eric Winer
Hyman Muss
Author Affiliation
Dana-Farber Cancer Institute, 44 Binney St, Boston, MA 02115, USA. ahpartridge@partners.org
Source
J Clin Oncol. 2010 May 10;28(14):2418-22
Date
May-10-2010
Language
English
Publication Type
Article
Keywords
Administration, Oral
Age Factors
Aged
Aged, 80 and over
Antimetabolites, Antineoplastic - administration & dosage - adverse effects
Breast Neoplasms - drug therapy - mortality - pathology - surgery
Canada
Chemotherapy, Adjuvant
Deoxycytidine - administration & dosage - adverse effects - analogs & derivatives
Drug Administration Schedule
Drug Monitoring - instrumentation
Female
Fluorouracil - administration & dosage - adverse effects - analogs & derivatives
Humans
Kaplan-Meier Estimate
Linear Models
Logistic Models
Mastectomy
Medication Adherence
Micro-Electrical-Mechanical Systems - instrumentation
Neoplasm Staging
Risk assessment
Risk factors
Time Factors
Treatment Outcome
United States
Abstract
Patient adherence is critical in evaluating the effectiveness of an oral therapy. We sought to measure adherence among women randomly assigned to capecitabine in a preplanned substudy of a multicenter clinical trial.
Cancer and Leukemia Group B study CALGB 49907 was a randomly assigned trial comparing standard chemotherapy versus oral chemotherapy with capecitabine in patients age 65 years or older with early-stage breast cancer. We used microelectronic monitoring system (MEMS) caps on participants' capecitabine bottles to record pill bottle openings. Capecitabine was given in two divided daily doses for 14 consecutive days of a 21-day cycle for six cycles. Adherence was calculated as the number of doses taken divided by doses expected, taking into account toxicity-related dosing changes. A participant was defined as adherent if 80% or more of expected doses were recorded by MEMS.
Overall, 161 patients were enrolled. Median age was 71 years (range, 65 to 89 years); 124 patients (83%) persisted with capecitabine to completion of planned protocol therapy. Adherence was 78% across all cycles, and adherence did not vary by cycle (P = .32). Twenty-five percent of participants took fewer than 80% of expected doses and were nonadherent. In a logistic regression model, participants with node-negative disease (P = .01) and mastectomy (P = .01) were more likely to be nonadherent. Adherence was not related to age, tumor stage, or hormone receptor status. Adherence was not significantly associated with relapse-free survival or grade 3 or 4 toxicity.
Most older women with early-stage breast cancer were adherent to short-term oral chemotherapy in a randomized clinical trial. Age was not associated with adherence.
Notes
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PubMed ID
20368559 View in PubMed
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Adherence and plasma HIV RNA response to antiretroviral therapy among HIV-seropositive injection drug users in a Canadian setting.

https://arctichealth.org/en/permalink/ahliterature135422
Source
AIDS Care. 2011 Aug;23(8):980-7
Publication Type
Article
Date
Aug-2011
Author
Seonaid Nolan
M-J Milloy
Ruth Zhang
Thomas Kerr
Robert S Hogg
Julio S G Montaner
Evan Wood
Author Affiliation
BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.
Source
AIDS Care. 2011 Aug;23(8):980-7
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Adult
Anti-HIV Agents - therapeutic use
Antiretroviral Therapy, Highly Active - statistics & numerical data
Canada
Cohort Studies
Drug Users - psychology
Female
HIV Infections - blood - drug therapy - psychology
Humans
Kaplan-Meier Estimate
Male
Medication Adherence
Middle Aged
Patient compliance
Proportional Hazards Models
RNA, Viral - blood - drug effects
Substance Abuse, Intravenous
Treatment Outcome
Young Adult
Abstract
HIV-positive individuals who use injection drugs (IDU) may have lower rates of adherence to highly active antiretroviral therapy (ART). However, previous studies of factors associated with adherence to ART among IDU have been limited primarily to samples drawn from clinical settings and in areas with financial barriers to healthcare.We evaluated patterns of ART adherence and rates of plasma HIV RNA response among a Canadian cohort of community-recruited IDU. Using data from a community-recruited cohort of antiretroviral-naive HIV-infected IDU, we investigated ART adherence patterns based on prescription refill compliance and factors associated with time to plasma HIV-1 RNA suppression (
PubMed ID
21480010 View in PubMed
Less detail
Source
Scand J Gastroenterol. 2016 Nov;51(11):1326-31
Publication Type
Article
Date
Nov-2016
Author
Palle Bager
Mette Julsgaard
Thea Vestergaard
Lisbet Ambrosius Christensen
Jens Frederik Dahlerup
Source
Scand J Gastroenterol. 2016 Nov;51(11):1326-31
Date
Nov-2016
Language
English
Publication Type
Article
Keywords
Adult
Anti-Inflammatory Agents, Non-Steroidal - classification - therapeutic use
Decision Making
Denmark
Female
Humans
Inflammatory Bowel Diseases - drug therapy
Logistic Models
Male
Medication Adherence - statistics & numerical data
Middle Aged
Odds Ratio
Patient satisfaction
Quality of Health Care - standards
Risk factors
Surveys and Questionnaires
Tertiary Care Centers
Young Adult
Abstract
In inflammatory bowel disease (IBD), adherence to both medical treatment and other aspects of care has a substantial impact on the course of the disease. Most studies of medical adherence have reported that 30-45% of patients with IBD were non-adherent. Our study aimed to investigate the different aspects of adherence and to identify predictors of non-adherence, including the quality of care, for outpatients with IBD.
An anonymous electronic questionnaire was used to investigate different aspects of adherence, the quality of care, patient involvement and shared decision making among 377 IBD outpatients.
Three hundred (80%) filled in the questionnaire. The overall adherence rate was 93%. Young age (
PubMed ID
27311071 View in PubMed
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Adherence level of antihypertensive agents in coronary artery disease.

https://arctichealth.org/en/permalink/ahliterature146044
Source
Br J Clin Pharmacol. 2010 Jan;69(1):74-84
Publication Type
Article
Date
Jan-2010
Author
Sylvie Perreault
Alice Dragomir
Louise Roy
Michel White
Lucie Blais
Lyne Lalonde
Anick Bérard
Author Affiliation
Faculties of Pharmacy and Medicine, University of Montreal, Montreal, Quebec, Canada. sylvie.perreault@umontreal.ca
Source
Br J Clin Pharmacol. 2010 Jan;69(1):74-84
Date
Jan-2010
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Antihypertensive Agents - therapeutic use
Case-Control Studies
Cohort Studies
Coronary Artery Disease - epidemiology - etiology - prevention & control
Diabetes Complications - prevention & control
Dyslipidemias - complications
Female
Humans
Hypertension - drug therapy
Incidence
Male
Medication Adherence
Middle Aged
Primary prevention - methods
Quebec - epidemiology
Risk factors
Survival Analysis
Abstract
* Non-adherence is probably an important source of preventable cardiovascular morbidity and mortality. * However, until now there have been very few large effectiveness studies assessing the relationship between adherence levels to antihypertensive medication and major cardiovascular outcomes for primary prevention of cardiovascular disease.
* The study results suggest that there is an association between better adherence to antihypertensive agents and a relative risk reduction of coronary artery disease. * Adherence to antihypertensive agents needs to be improved so that patients can benefit from the full protective effects of antihypertensive therapies.
Antihypertensive (AH) agents have been shown to reduce the risk of cardiovascular events, including coronary artery disease (CAD). Previous surveys have shown that a substantial number of patients with diagnosed hypertension remain uncontrolled. Non-adherence to AH agents may reduce the effectiveness. The aim was to evaluate the impact of better adherence to AH agents on the occurrence of CAD in a real clinical setting.
A cohort of 83 267 patients was reconstructed using the Régie de l'assurance maladie du Québec databases. Patients were eligible if they were between 45 and 85 years of age without indication of cardiovascular disease, and had been newly treated with AH agents between 1999 and 2004. A nested case-control design was used to study the incidence of CAD. Every case of CAD was matched for age and duration of follow-up to up to 15 randomly selected controls. The adherence level was measured by calculating the medication possession ratio. Cases' adherence was calculated from the start of follow-up to the time of the CAD (index date). For controls, adherence was calculated from the start of follow-up to the time of selection (index date). Rate ratios of CAD were estimated by conditional logistic regression adjusting for covariables.
The mean patient age was 65 years, 37% were male, 8% had diabetes and 18% had dyslipidaemia. High adherence level (96%) to AH therapy compared with lower adherence level (59%) was associated with a relative risk reduction of CAD events (rate ratios 0.90; 0.84, 0.95). Risk factors for CAD were male gender, diabetes, dyslipidaemia and developing a cardiovascular condition disease during follow-up.
Our study suggests that better adherence to AH agents is associated with a risk reduction of CAD. Adherence to AH agents needs to be improved so that patients can benefit from the full protective effects of AH therapies.
Notes
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PubMed ID
20078615 View in PubMed
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[Adherence of patients with stable angina to treatment with trimetazidine MR and frequency of emergency medical care: results of the EFFECT study].

https://arctichealth.org/en/permalink/ahliterature118141
Source
Kardiologiia. 2012;52(11):4-11
Publication Type
Article
Date
2012
Author
M G Glezer
R T Saigitov
Source
Kardiologiia. 2012;52(11):4-11
Date
2012
Language
Russian
Publication Type
Article
Keywords
Aged
Angina, Stable - drug therapy - epidemiology - physiopathology - psychology
Drug Monitoring - methods
Drug Substitution - statistics & numerical data
Electrocardiography
Emergencies - epidemiology
Emergency Medical Services - statistics & numerical data
Episode of Care
Female
Hospitalization - statistics & numerical data
Humans
Male
Medication Adherence - statistics & numerical data
Middle Aged
Outcome and Process Assessment (Health Care)
Prospective Studies
Risk assessment
Risk factors
Russia - epidemiology
Therapeutic Equivalency
Treatment Outcome
Trimetazidine - administration & dosage - pharmacokinetics
Vasodilator Agents - administration & dosage - pharmacokinetics
Abstract
The adherence of patients with stable angina to antianginal therapy is the key factor of controlling the disease. The purpose of the study was to evaluate the relationship of adherence of patients with stable angina to treatment with trimetazidine modified release (MR) with frequency (risk) of emergency medical care. We consistently included in the study patients with stable angina in primary health care. The results of treatment for 16 weeks were monitored at patients with angina attacks three times per week or more, use of short nitrate and treatment with generic trimetazidine. To strengthen the antianginal therapy generic was replaced with original trimetazidine MR. Adherence is considered relatively high while taking 80-120% of the recommended dose of the drug (70 mg/day). The effectiveness of treatment evaluated by the frequency of emergency hospitalizations and/or ambulance calls because of the pain, discomfort, tightness in the chest or ischemic changes on the electrocardiogram. 870 patients were included in the study, the results of treatment in 185 were assessed. Patients with a relatively high adherence to trimetazidine MR (n=151) were used (median) 99% (98, 104), with low (<80%, n=34) adherence - 67% (49, 76) of the recommended dose of the drug. During the study period, the primary end point is fixed in 7 (21%) patients with low and in 18 (12%) - with relatively high adherence (p=0.182). The number of angina attacks, having necessitated taking short-nitrate, decreased in the groups, respectively, with 5 (3; 10) and 6 (4; 10) to 2 (1; 3) per week (p=0.791). Thus, replacing generic trimetazidine with original trimetazidine MR in patients with a high frequency of angina attacks can achieve significant antianginal effect. Adherence of patients to the reception of the drug by an average 1/3 below the recommended amount does not affect the risk of emergency hospitalizations and/or ambulance calls for 16 weeks.
PubMed ID
23237390 View in PubMed
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Adherence of Renal Transplant Recipients to Once-daily, Prolonged-Release and Twice-daily, Immediate-release Tacrolimus-based Regimens in a Real-life Setting in Sweden.

https://arctichealth.org/en/permalink/ahliterature298202
Source
Transplant Proc. 2018 Dec; 50(10):3275-3282
Publication Type
Journal Article
Date
Dec-2018
Author
B Fellström
J Holmdahl
N Sundvall
E Cockburn
S Kilany
L Wennberg
Author Affiliation
Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Electronic address: bengt.fellstrom@medsci.uu.se.
Source
Transplant Proc. 2018 Dec; 50(10):3275-3282
Date
Dec-2018
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Delayed-Action Preparations
Drug Administration Schedule
Female
Graft Rejection - prevention & control
Humans
Immunosuppressive Agents - administration & dosage
Kidney Transplantation
Male
Medication Adherence
Middle Aged
Sweden
Tacrolimus - administration & dosage
Transplant Recipients
Abstract
In this study we investigated medication adherence of kidney transplant patients (KTPs) to an immediate-release tacrolimus (IR-T) regimen and, after conversion, to a prolonged-release tacrolimus (PR-T) regimen in routine clinical practice.
This was a non-interventional, observational, multicenter Swedish study. We included adult KTPs with stable graft function, remaining on IR-T or converting from IR-T to PR-T. Data were collected at baseline, and months 3, 6, and 12 post-baseline. The primary endpoint was adherence using the Basel Assessment of Adherence to Immunosuppressive Medication Scale (BAASIS©). Secondary assessments included tacrolimus dose and trough levels, clinical laboratory parameters (eg, estimated glomerular filtration rate), and adverse drug reactions (ADRs).
Overall, data from 233 KTPs were analyzed (PR-T, n = 175; IR-T, n = 58). Mean change in PR-T dose from baseline (4.8 mg/d) to month 12 was -0.2 mg/d, and for IR-T (4.2 mg/d) was -0.4 mg/d; tacrolimus trough levels remained similar. Overall adherence was similar between baseline and month 12 in both groups (PR-T: 54.4% vs 57.0%, respectively; IR-T: 65.5% vs 69.4%); timing adherence followed a similar pattern. The probability of taking adherence improved between baseline and month 12 (odds ratio, 1.97; P = .0092) in the PR-T group only. Mean BAASIS visual analog scale score at baseline was 94.3 ± 11.1% (PR-T) and 95.3 ± 7.6% (IR-T), and >95% at subsequent visits. Laboratory parameters remained stable. Eight (4.6%) patients receiving PR-T (none receiving IR-T) had ADRs considered probably/possibly treatment-related.
Disparity existed between high, patient-perceived and low, actual adherence. Overall adherence to the immunosuppressive regimen (measured by BAASIS) did not improve significantly over 12 months in stable KTPs converting to PR-T or remaining on IR-T; renal function remained stable.
PubMed ID
30577197 View in PubMed
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Adherence, persistence and switch rates for anticholinergic drugs used for overactive bladder in women: data from the Norwegian Prescription Database.

https://arctichealth.org/en/permalink/ahliterature113114
Source
Acta Obstet Gynecol Scand. 2013 Oct;92(10):1208-15
Publication Type
Article
Date
Oct-2013
Author
Siri A Mauseth
Svetlana Skurtveit
Olav Spigset
Author Affiliation
Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
Source
Acta Obstet Gynecol Scand. 2013 Oct;92(10):1208-15
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Benzhydryl Compounds - therapeutic use
Benzofurans - therapeutic use
Cholinergic Antagonists - therapeutic use
Cresols - therapeutic use
Databases, Pharmaceutical
Drug Substitution - statistics & numerical data
Female
Follow-Up Studies
Humans
Medication Adherence - statistics & numerical data
Middle Aged
Norway
Phenylpropanolamine - therapeutic use
Pyrrolidines - therapeutic use
Quinuclidines - therapeutic use
Tetrahydroisoquinolines - therapeutic use
Urinary Bladder, Overactive - drug therapy
Young Adult
Abstract
To investigate the pattern of use of anticholinergic drugs for overactive bladder among women in Norway with regard to persistence, adherence and switch rates.
Observational study.
Data from the Norwegian Prescription Database on prescriptions for tolterodine, solifenacin, darifenacin and fesoterodine filled in Norwegian pharmacies from 1 January 2004 to 31 December 2010.
Data from the database were analysed at an individual level, and drug persistence, discontinuation rates and switch rates during a follow-up period of 365 days after the first prescription were calculated.
Overall 1-year persistence for new users was 38.0%. Within the same period, a total of 10.3% switched from the index drug to another drug in the same group, whereas 51.7% discontinued without switching. Users of solifenacin and tolterodine were somewhat more persistent than users of darifenacin and fesoterodine. Persistence was lowest (20.9%) in the age group 18-39 years, increased with age and was highest in the age groups 70-79 years and 80 years and above (43.5 and 43.3%, respectively). In total, 31.9% filled only one prescription of the drug and, of these, only one of four women switched to another drug. The proportion who were adherent during treatment was 60.4%.
The discontinuation rate for anticholinergic drugs for overactive bladder in women is high. The reasons why patients stop using them remain obscure but could be related both to a limited clinical effect and an unacceptable adverse effect burden.
PubMed ID
23763552 View in PubMed
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