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A model-based meta-analysis of the influence of factors that impact adherence to medications

2014; Wiley; Volume: 40; Issue: 1 Linguagem: Inglês

10.1111/jcpt.12219

1365-2710

Piyanan Assawasuwannakit, Rhiannon Braund, Stephen B. Duffull,

Bipolar Disorder and Treatment

Journal of Clinical Pharmacy and TherapeuticsVolume 40, Issue 1 p. 24-31 Original Article A model-based meta-analysis of the influence of factors that impact adherence to medications P. Assawasuwannakit BSc(Pharm) PGCertPharm, Corresponding Author P. Assawasuwannakit BSc(Pharm) PGCertPharm School of Pharmacy, University of Otago, Dunedin, New Zealand Correspondence: P. Assawasuwannakit, School of Pharmacy, University of Otago, PO Box 56, Dunedin 9054, New Zealand. Tel.: +64 3 4795045; fax: +64 3 4797034; e-mail: piyanan.assawasuwannakit@otago.ac.nzSearch for more papers by this authorR. Braund PhD, R. Braund PhD School of Pharmacy, University of Otago, Dunedin, New ZealandSearch for more papers by this authorS. B. Duffull PhD, S. B. Duffull PhD School of Pharmacy, University of Otago, Dunedin, New ZealandSearch for more papers by this author P. Assawasuwannakit BSc(Pharm) PGCertPharm, Corresponding Author P. Assawasuwannakit BSc(Pharm) PGCertPharm School of Pharmacy, University of Otago, Dunedin, New Zealand Correspondence: P. Assawasuwannakit, School of Pharmacy, University of Otago, PO Box 56, Dunedin 9054, New Zealand. Tel.: +64 3 4795045; fax: +64 3 4797034; e-mail: piyanan.assawasuwannakit@otago.ac.nzSearch for more papers by this authorR. Braund PhD, R. Braund PhD School of Pharmacy, University of Otago, Dunedin, New ZealandSearch for more papers by this authorS. B. Duffull PhD, S. B. Duffull PhD School of Pharmacy, University of Otago, Dunedin, New ZealandSearch for more papers by this author First published: 18 October 2014 https://doi.org/10.1111/jcpt.12219Citations: 11Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Summary What is known and objective Several studies have investigated factors that may influence adherence for a given disease. The influence of disease on adherence has received limited attention. Less work has been conducted to investigate the influence of other factors in conjunction with disease on adherence. The aim of this study was to determine the independent influence of disease and other factors on adherence. Methods A literature search was conducted to retrieve adherence studies using medication event monitoring system devices. Studies were categorized into different therapeutic areas. Only the two most commonly studied therapeutic areas were selected. Pseudopatient-level data were extracted from each study. The extracted data were analysed using a model-based meta-analysis technique. Univariate and multivariate models were developed. Model selection was based on a likelihood ratio test and visual plots. Results The most commonly studied therapeutic areas were HIV and hypertension. The most commonly recorded adherence criterion was percentage of prescribed doses taken per day. Based on this adherence criterion, ultimately, 24 HIV papers and 12 hypertension papers were included for data extraction. The statistically significant factors were disease, age and dosing regimen. The independent influences of each factor on adherence were as follows: an increase in adherence of approximately 8% per 10-year increase of age, a 15–19% reduction from once to thrice daily dosing and that patients with HIV were 5% more adherent than those with hypertension. What is new and conclusion Although the influence of disease on adherence was significant, it was of limited clinical significance in the diseases studied here. Adherence appears to improve with age and decline with more frequent dosing. Additionally, the influence of dosing regimen wanes with increasing age. These results should be treated as exploratory and require prospective assessment. Citing Literature Supporting Information Filename Description jcpt12219-sup-0001-AppendixS1.docxWord document, 18.6 KB Appendix S1 Study assumptions. jcpt12219-sup-0002-AppendixS2.docxWord document, 26.9 KB Appendix S2 Data characteristics. jcpt12219-sup-0003-AppendixS3.docxWord document, 13.3 KB Appendix S3 Diagnostic plots. jcpt12219-sup-0004-AppendixS3_Fig1.tifimage/tif, 80 KB jcpt12219-sup-0005-AppendixS3_Fig2.tifimage/tif, 47.8 KB jcpt12219-sup-0006-AppendixS3_Fig3.tifimage/tif, 61.1 KB jcpt12219-sup-0007-AppendixS3_Fig4.tifimage/tif, 53.9 KB Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article. Volume40, Issue1February 2015Pages 24-31 RelatedInformation