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Adherence to disease-specific drug treatment among patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension

Kjellström, Barbro LU ; Sandqvist, Anna ; Hjalmarsson, Clara ; Nisell, Magnus ; Näsman, Per and Ivarsson, Bodil LU (2020) In ERJ Open Research 6(4). p.299-2020
Abstract
Background Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) require lifelong treatment. The aim of the present study was to investigate adherence to disease-specific treatment in patients with PAH or CTEPH.Methods The study comprised an adult population diagnosed with PAH (n=384) or CTEPH (n=187) alive in 2016–2017. The study utilised three registries: the Swedish PAH registry, the National Board of Health and Welfare, and Statistics Sweden. Withdrawals from pharmacies of disease-specific oral treatments were studied. Adherence was assessed as: 1) Number of days covered defined as the difference between the total number of daily dosages dispensed and the total number of days covered; and 2)... (More)
Background Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) require lifelong treatment. The aim of the present study was to investigate adherence to disease-specific treatment in patients with PAH or CTEPH.Methods The study comprised an adult population diagnosed with PAH (n=384) or CTEPH (n=187) alive in 2016–2017. The study utilised three registries: the Swedish PAH registry, the National Board of Health and Welfare, and Statistics Sweden. Withdrawals from pharmacies of disease-specific oral treatments were studied. Adherence was assessed as: 1) Number of days covered defined as the difference between the total number of daily dosages dispensed and the total number of days covered; and 2) Manual assessment by two persons that independently reviewed each patient's prescription fill history to detect anomalies or patterns of deteriorating or improving adherence over time.Results The mean age was 61±16 years, 61% were female and mean time since diagnosis was 4.6 years. Adherence was 62% using the Number of days covered method and 66% by the Manual assessment method. Drug-specific adherence varied from 91% for riociguat to 60% for sildenafil. Good adherence was associated with shorter time since diagnosis in patients with PAH and with lower number of concomitant other chronic treatments in patients with CTEPH. Age, sex, socioeconomic status or number of pulmonary hypertension (PH) treatments were not associated with adherence.Conclusion Adherence to oral disease-specific treatment was 60–66% and associated with time since diagnosis and number of concomitant chronic treatments. Sex, age or socioeconomic factors did not affect adherence.Adherence to oral ERA and/or PDE-5i/SGC treatment is associated with time since diagnosis, while sex, gender, age and socioeconomic factors do not affect adherence in patients with PAH or CTEPH https://bit.ly/354NAOQ (Less)
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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
ERJ Open Research
volume
6
issue
4
pages
299 - 2020
publisher
European Respiratory Society
external identifiers
  • pmid:33313301
  • scopus:85114064751
ISSN
2312-0541
DOI
10.1183/23120541.00299-2020
language
English
LU publication?
yes
id
2a429d8a-6edf-4e9f-a42a-191fc88bf429
alternative location
http://openres.ersjournals.com/content/6/4/00299-2020.abstract
date added to LUP
2021-02-24 16:38:58
date last changed
2024-02-03 10:39:28
@article{2a429d8a-6edf-4e9f-a42a-191fc88bf429,
  abstract     = {{Background Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) require lifelong treatment. The aim of the present study was to investigate adherence to disease-specific treatment in patients with PAH or CTEPH.Methods The study comprised an adult population diagnosed with PAH (n=384) or CTEPH (n=187) alive in 2016–2017. The study utilised three registries: the Swedish PAH registry, the National Board of Health and Welfare, and Statistics Sweden. Withdrawals from pharmacies of disease-specific oral treatments were studied. Adherence was assessed as: 1) Number of days covered defined as the difference between the total number of daily dosages dispensed and the total number of days covered; and 2) Manual assessment by two persons that independently reviewed each patient's prescription fill history to detect anomalies or patterns of deteriorating or improving adherence over time.Results The mean age was 61±16 years, 61% were female and mean time since diagnosis was 4.6 years. Adherence was 62% using the Number of days covered method and 66% by the Manual assessment method. Drug-specific adherence varied from 91% for riociguat to 60% for sildenafil. Good adherence was associated with shorter time since diagnosis in patients with PAH and with lower number of concomitant other chronic treatments in patients with CTEPH. Age, sex, socioeconomic status or number of pulmonary hypertension (PH) treatments were not associated with adherence.Conclusion Adherence to oral disease-specific treatment was 60–66% and associated with time since diagnosis and number of concomitant chronic treatments. Sex, age or socioeconomic factors did not affect adherence.Adherence to oral ERA and/or PDE-5i/SGC treatment is associated with time since diagnosis, while sex, gender, age and socioeconomic factors do not affect adherence in patients with PAH or CTEPH https://bit.ly/354NAOQ}},
  author       = {{Kjellström, Barbro and Sandqvist, Anna and Hjalmarsson, Clara and Nisell, Magnus and Näsman, Per and Ivarsson, Bodil}},
  issn         = {{2312-0541}},
  language     = {{eng}},
  month        = {{10}},
  number       = {{4}},
  pages        = {{299--2020}},
  publisher    = {{European Respiratory Society}},
  series       = {{ERJ Open Research}},
  title        = {{Adherence to disease-specific drug treatment among patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension}},
  url          = {{http://dx.doi.org/10.1183/23120541.00299-2020}},
  doi          = {{10.1183/23120541.00299-2020}},
  volume       = {{6}},
  year         = {{2020}},
}