Medication Adherence and Attrition to Biologic Treatment in Rheumatoid Arthritis Patients

Li Hao Chu, Aniket A. Kawatkar, Sherine E. Gabriel

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose The objectives of this study were to assess medication adherence rate and attrition rate in first-time adalimumab (ADA) or etanercept (ETA) users in rheumatoid arthritis (RA) patients. This study also identified the risk factors associated with nonadherence and treatment abandonment. Methods This was a retrospective study with a 2-year follow-up. A total 2151 adult RA patients (18 years of age and older) who initiated ADA or ETA treatment in the Kaiser Permanente Southern California health plan between 2002 and 2009 were identified. Among those on treatment in the first year, continuous treatment receipt was determined by having at least 1 medication refill in the second year; otherwise treatment was considered as abandoned. Medication adherence was measured through proportion of days covered (PDC) and compared between patients continuously on treatment and those abandoning treatment. Risk factors of nonadherence (PDC <80%) and treatment abandonment were estimated by a multinomial logistic regression model. Findings Patients who abandoned treatment had significantly lower PDC (37.3%) and lower average number of refills (5.1) than adherers (PDC = 88.8%; average number of refills = 12.4) and nonadherers (PDC = 53.3%; average refills = 8.2). Age, African Americans (odds ratio [OR], 1.49; 95% CI, 1.03-2.17), corticosteroids use (OR, 0.80; 95% CI, 0.63-0.98), and history of physical/occupational therapy (OR = 0.66; 95% CI, 0.46-0.93) were associated with nonadherence, whereas having a comorbidity (OR, 1.24; 95% CI, 1.01-1.57) was associated with treatment abandonment. The difference in PDC between ADA and ETA was no longer statistically significant after excluding the treatment abandonment group. A higher proportion of ADA users abandoned treatment than ETA users (42.9% vs 32.2%). Implications Taking into account treatment abandonment when measuring medication adherence in ADA and ETA use in RA patients can provide a fair and clinically meaningful view of patients' medication-taking behavior.

Original languageEnglish (US)
Pages (from-to)660-666.e8
JournalClinical Therapeutics
Volume37
Issue number3
DOIs
StatePublished - Mar 1 2015

Fingerprint

Medication Adherence
Rheumatoid Arthritis
Therapeutics
Odds Ratio
Logistic Models
Occupational Therapy
African Americans
Comorbidity
Adrenal Cortex Hormones
Retrospective Studies

Keywords

  • anti-TNF
  • med- ication attrition rate
  • medication adherence
  • rheumatoid arthritis
  • treatment abandonment

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

Medication Adherence and Attrition to Biologic Treatment in Rheumatoid Arthritis Patients. / Chu, Li Hao; Kawatkar, Aniket A.; Gabriel, Sherine E.

In: Clinical Therapeutics, Vol. 37, No. 3, 01.03.2015, p. 660-666.e8.

Research output: Contribution to journalArticle

Chu, Li Hao ; Kawatkar, Aniket A. ; Gabriel, Sherine E. / Medication Adherence and Attrition to Biologic Treatment in Rheumatoid Arthritis Patients. In: Clinical Therapeutics. 2015 ; Vol. 37, No. 3. pp. 660-666.e8.
@article{72b87fd0922749d3bef13d67d34a58c4,
title = "Medication Adherence and Attrition to Biologic Treatment in Rheumatoid Arthritis Patients",
abstract = "Purpose The objectives of this study were to assess medication adherence rate and attrition rate in first-time adalimumab (ADA) or etanercept (ETA) users in rheumatoid arthritis (RA) patients. This study also identified the risk factors associated with nonadherence and treatment abandonment. Methods This was a retrospective study with a 2-year follow-up. A total 2151 adult RA patients (18 years of age and older) who initiated ADA or ETA treatment in the Kaiser Permanente Southern California health plan between 2002 and 2009 were identified. Among those on treatment in the first year, continuous treatment receipt was determined by having at least 1 medication refill in the second year; otherwise treatment was considered as abandoned. Medication adherence was measured through proportion of days covered (PDC) and compared between patients continuously on treatment and those abandoning treatment. Risk factors of nonadherence (PDC <80{\%}) and treatment abandonment were estimated by a multinomial logistic regression model. Findings Patients who abandoned treatment had significantly lower PDC (37.3{\%}) and lower average number of refills (5.1) than adherers (PDC = 88.8{\%}; average number of refills = 12.4) and nonadherers (PDC = 53.3{\%}; average refills = 8.2). Age, African Americans (odds ratio [OR], 1.49; 95{\%} CI, 1.03-2.17), corticosteroids use (OR, 0.80; 95{\%} CI, 0.63-0.98), and history of physical/occupational therapy (OR = 0.66; 95{\%} CI, 0.46-0.93) were associated with nonadherence, whereas having a comorbidity (OR, 1.24; 95{\%} CI, 1.01-1.57) was associated with treatment abandonment. The difference in PDC between ADA and ETA was no longer statistically significant after excluding the treatment abandonment group. A higher proportion of ADA users abandoned treatment than ETA users (42.9{\%} vs 32.2{\%}). Implications Taking into account treatment abandonment when measuring medication adherence in ADA and ETA use in RA patients can provide a fair and clinically meaningful view of patients' medication-taking behavior.",
keywords = "anti-TNF, med- ication attrition rate, medication adherence, rheumatoid arthritis, treatment abandonment",
author = "Chu, {Li Hao} and Kawatkar, {Aniket A.} and Gabriel, {Sherine E.}",
year = "2015",
month = "3",
day = "1",
doi = "10.1016/j.clinthera.2014.10.022",
language = "English (US)",
volume = "37",
pages = "660--666.e8",
journal = "Clinical Therapeutics",
issn = "0149-2918",
publisher = "Excerpta Medica",
number = "3",

}

TY - JOUR

T1 - Medication Adherence and Attrition to Biologic Treatment in Rheumatoid Arthritis Patients

AU - Chu, Li Hao

AU - Kawatkar, Aniket A.

AU - Gabriel, Sherine E.

PY - 2015/3/1

Y1 - 2015/3/1

N2 - Purpose The objectives of this study were to assess medication adherence rate and attrition rate in first-time adalimumab (ADA) or etanercept (ETA) users in rheumatoid arthritis (RA) patients. This study also identified the risk factors associated with nonadherence and treatment abandonment. Methods This was a retrospective study with a 2-year follow-up. A total 2151 adult RA patients (18 years of age and older) who initiated ADA or ETA treatment in the Kaiser Permanente Southern California health plan between 2002 and 2009 were identified. Among those on treatment in the first year, continuous treatment receipt was determined by having at least 1 medication refill in the second year; otherwise treatment was considered as abandoned. Medication adherence was measured through proportion of days covered (PDC) and compared between patients continuously on treatment and those abandoning treatment. Risk factors of nonadherence (PDC <80%) and treatment abandonment were estimated by a multinomial logistic regression model. Findings Patients who abandoned treatment had significantly lower PDC (37.3%) and lower average number of refills (5.1) than adherers (PDC = 88.8%; average number of refills = 12.4) and nonadherers (PDC = 53.3%; average refills = 8.2). Age, African Americans (odds ratio [OR], 1.49; 95% CI, 1.03-2.17), corticosteroids use (OR, 0.80; 95% CI, 0.63-0.98), and history of physical/occupational therapy (OR = 0.66; 95% CI, 0.46-0.93) were associated with nonadherence, whereas having a comorbidity (OR, 1.24; 95% CI, 1.01-1.57) was associated with treatment abandonment. The difference in PDC between ADA and ETA was no longer statistically significant after excluding the treatment abandonment group. A higher proportion of ADA users abandoned treatment than ETA users (42.9% vs 32.2%). Implications Taking into account treatment abandonment when measuring medication adherence in ADA and ETA use in RA patients can provide a fair and clinically meaningful view of patients' medication-taking behavior.

AB - Purpose The objectives of this study were to assess medication adherence rate and attrition rate in first-time adalimumab (ADA) or etanercept (ETA) users in rheumatoid arthritis (RA) patients. This study also identified the risk factors associated with nonadherence and treatment abandonment. Methods This was a retrospective study with a 2-year follow-up. A total 2151 adult RA patients (18 years of age and older) who initiated ADA or ETA treatment in the Kaiser Permanente Southern California health plan between 2002 and 2009 were identified. Among those on treatment in the first year, continuous treatment receipt was determined by having at least 1 medication refill in the second year; otherwise treatment was considered as abandoned. Medication adherence was measured through proportion of days covered (PDC) and compared between patients continuously on treatment and those abandoning treatment. Risk factors of nonadherence (PDC <80%) and treatment abandonment were estimated by a multinomial logistic regression model. Findings Patients who abandoned treatment had significantly lower PDC (37.3%) and lower average number of refills (5.1) than adherers (PDC = 88.8%; average number of refills = 12.4) and nonadherers (PDC = 53.3%; average refills = 8.2). Age, African Americans (odds ratio [OR], 1.49; 95% CI, 1.03-2.17), corticosteroids use (OR, 0.80; 95% CI, 0.63-0.98), and history of physical/occupational therapy (OR = 0.66; 95% CI, 0.46-0.93) were associated with nonadherence, whereas having a comorbidity (OR, 1.24; 95% CI, 1.01-1.57) was associated with treatment abandonment. The difference in PDC between ADA and ETA was no longer statistically significant after excluding the treatment abandonment group. A higher proportion of ADA users abandoned treatment than ETA users (42.9% vs 32.2%). Implications Taking into account treatment abandonment when measuring medication adherence in ADA and ETA use in RA patients can provide a fair and clinically meaningful view of patients' medication-taking behavior.

KW - anti-TNF

KW - med- ication attrition rate

KW - medication adherence

KW - rheumatoid arthritis

KW - treatment abandonment

UR - http://www.scopus.com/inward/record.url?scp=84939977664&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84939977664&partnerID=8YFLogxK

U2 - 10.1016/j.clinthera.2014.10.022

DO - 10.1016/j.clinthera.2014.10.022

M3 - Article

VL - 37

SP - 660-666.e8

JO - Clinical Therapeutics

JF - Clinical Therapeutics

SN - 0149-2918

IS - 3

ER -