Adherence to Adalimumab Was Not Improved by a Reminder-Based Intervention with an Electronic Needle Container
| Autor: | Sandra Altena, Herma H. Fidder, Max R. Clevers, Johannes P. D. Schultheiss, Bindia Jharap, Dominique Baas |
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| Rok vydání: | 2020 |
| Předmět: |
Crohn’s disease
Adult Male medicine.medical_specialty Time Factors Physiology Reminder Systems Pharmacy Inflammatory bowel disease Drug Administration Schedule Injections Medication Adherence Anti-TNF 03 medical and health sciences 0302 clinical medicine Crohn Disease Internal medicine Clinical endpoint medicine Adalimumab Humans Netherlands Crohn's disease business.industry Gastroenterology Odds ratio Middle Aged medicine.disease Ulcerative colitis Treatment Outcome 030220 oncology & carcinogenesis Original Article Colitis Ulcerative Female Tumor Necrosis Factor Inhibitors 030211 gastroenterology & hepatology Observational study business medicine.drug |
| Zdroj: | Digestive Diseases and Sciences |
| ISSN: | 1573-2568 0163-2116 |
| Popis: | Background Adherence to adalimumab in inflammatory bowel disease (IBD) patients is reported to be below par. Non-adherence may result in loss-of-response and increased hospitalization. We analyzed the effect of an electronic needle container (ENC) on adherence to adalimumab. Methods In this multicenter, 12-months observational study, we included adalimumab treated IBD patients. All patients were invited to receive an ENC. Patients who declined or did not complete the registration for an ENC served as controls. Primary endpoint was whether an ENC increased adherence, calculated from pharmacy refills as proportion of days covered (PDC). Secondary endpoints were clinical outcomes, including loss-of-response, identification of predictors of adherence and correlation between different modalities for measuring adherence. Loss-of-response was defined as a disease flare, dose-escalation or IBD-related hospitalization or surgery. Results The pharmacies’ records identified 198 eligible patients, of whom 32 were excluded. The ENC was supplied to 69 patients, the remaining 97 patient formed the control group. Median baseline PDC (98.4% vs. 96.1%, p = 0.047) and the proportion of adherent (PDC ≥ 86%) patients (87.0% vs. 74.2%, p = 0.045) was higher for the ENC group. The ENC did not improve the adherence of patients during follow-up (odds ratio 1.26, 95% CI 0.55–2.86). During follow-up, five (7.2%) patients in the ENC group and 13 (13.4%) in the control group discontinued adalimumab (log-rank p = 0.22). Loss-of-response occurred in 12 (17.4%) and 14 (14.4%) patients, respectively (log-rank p = 0.66). Conclusions Our results show no beneficial effect of a reminder-based intervention on adherence or treatment outcomes. |
| Databáze: | OpenAIRE |
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