Evaluation of adherence to antipsychotics: A real-world data study using four different dosing assumptions.

Journal: British journal of clinical pharmacology

Volume: 

Issue: 

Year of Publication: 

Affiliated Institutions:  Health Technology Assessment in Primary Care and Mental Health (PRISMA) Research Group, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain. Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain. Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain. Unitat de Farmàcia. Regió Sanitària Metropolitana Sud CatSalut, Barcelona, Spain.

Abstract summary 

This study aimed to assess the frequency of dosing inconsistencies in prescription data and the effect of four dosing assumption strategies on adherence estimates for antipsychotic treatment.A retrospective cohort, which linked prescription and dispensing data of adult patients with ≥1 antipsychotic prescription between 2015-2016 and followed up until 2019, in Catalonia (Spain). Four strategies were proposed for selecting the recommended dosing in overlapping prescription periods for the same patient and antipsychotic drug: (i) the minimum dosing prescribed; (ii) the dose corresponding to the latest prescription issued; (iii) the highest dosing prescribed; and (iv) all doses included in the overlapped period. For each strategy, one treatment episode per patient was selected, and the Continuous Medication Availability measure was used to assess adherence. Descriptive statistics were used to describe results by strategy.Of the 277 324 prescriptions included, 76% overlapped with other prescriptions (40% with different recommended dosing instructions). The number and characteristics of patients and treatment episodes (18 292, 18 303, 18 339 and 18 536, respectively per strategy) were similar across strategies. Mean adherence was similar between strategies, ranging from 57 to 60%. However, the proportion of patients with adherence ≥90% was lower when selecting all doses (28%) compared with the other strategies (35%).Despite the high prevalence of overlapping prescriptions, the strategies proposed did not show a major effect on the adherence estimates for antipsychotic treatment. Taking into consideration the particularities of antipsychotic prescription practices, selecting the highest dose in the overlapped period seemed to provide a more accurate adherence estimate.

Authors & Co-authors:  Fuente-Moreno Dima Rubio-Valera Baladon Chavarria Contaldo Peña-Salazar Serra-Sutton Hermida-González de Loño Rey-Abella Aznar-Lou Serrano-Blanco

Study Outcome 

Source Link: Visit source

Statistics
Citations :  Lehmann A, Aslani P, Ahmed R, et al. Assessing medication adherence: options to consider. Int J Clin Pharmacol. 2014;36(1):55-69. doi:10.1007/S11096-013-9865-X
Authors :  13
Identifiers
Doi : 10.1111/bcp.16042
SSN : 1365-2125
Study Population
Male,Female
Mesh Terms
Other Terms
antipsychotic agents;electronic health records;medication adherence;pharmacoepidemiology;prescribing patterns;real-world data
Study Design
Study Approach
Country of Study
Publication Country
England