Electronic monitoring reveals highly variable adherence patterns in patients prescribed ivacaftor

Previous studies of CF treatments have shown suboptimal adherence, though little has been reported regarding adherence patterns to ivacaftor. Electronic monitoring (EM) of adherence is considered a gold standard of measurement. Adherence rates by EM were prospectively obtained and patterns over time...

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Bibliographic Details
Published in:Journal of cystic fibrosis Vol. 14; no. 5; pp. 621 - 626
Main Authors: Siracusa, Christopher M., Ryan, Jamie, Burns, Lisa, Wang, Yu, Zhang, Nanhua, Clancy, John P., Drotar, Dennis
Format: Journal Article
Language:English
Published: Netherlands Elsevier B.V 01.09.2015
Subjects:
Adherence
Adolescent
Adult
Aminophenols - therapeutic use
Automatic Data Processing - methods
Child
Clinical Pharmacy Information Systems
Cystic Fibrosis - drug therapy
Cystic Fibrosis Transmembrane Conductance Regulator
Drug Monitoring - methods
Drug Prescriptions - statistics & numerical data
Female
Humans
Male
Medication Adherence - statistics & numerical data
Middle Aged
Pediatric
Potentiator
Prospective Studies
Pulmonary/Respiratory
Quinolones - therapeutic use
Young Adult
Adherence
SD
CF
Potentiator
EM
MEMS
FEV1PP
Pediatric
CFTR
MPR
BMI
body mass index
electronic monitoring
Medication Events Monitoring System
forced expiratory volume in 1 second percent predicted
medication possession ratio
cystic fibrosis
cystic fibrosis transmembrane conductance regulator
standard deviation
ISSN:1569-1993, 1873-5010, 1873-5010
Online Access:Get full text
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Summary:Previous studies of CF treatments have shown suboptimal adherence, though little has been reported regarding adherence patterns to ivacaftor. Electronic monitoring (EM) of adherence is considered a gold standard of measurement. Adherence rates by EM were prospectively obtained and patterns over time were analyzed. EM-derived adherence rates were compared to pharmacy refill history and self-report. 12 subjects (age 6–48years; CFTR-G551D mutation) previously prescribed ivacaftor were monitored for a mean of 118days. Overall adherence by EM was 61%(SD=28%) and decreased over time. Median duration between doses was 16.9hours (IQR 13.9–24.1hours) and increased over time. There was no correlation between EM-derived adherence and either refill history (84%, r=0.26, p=0.42) or self-report (100%, r=0.40, p=0.22). Despite the promising nature of ivacaftor, our data suggest adherence rates are suboptimal and comparable to other prescribed CF therapies, and more commonly used assessments of adherence may be unreliable.
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jamie.ryan@cchmc.org, lisa.burns2@cchmc.org, yu.wang@cchmc.org, nanhua.zhang@cchmc.org, john.clancy@cchmc.org; dennis.drotar@cchmc.org
ISSN:1569-1993
1873-5010
1873-5010
DOI:10.1016/j.jcf.2015.05.009