Electronic monitoring reveals highly variable adherence patterns in patients prescribed ivacaftor

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• 作者：Christopher M. Siracusa^a ; ^{christopher.siracusa@cchmc.org" class="auth_mail" title="E-mail the corresponding author} ; Jamie Ryan^b ; ^{jamie.ryan@cchmc.org" class="auth_mail" title="E-mail the corresponding author} ; Lisa Burns^a ; ^{lisa.burns2@cchmc.org" class="auth_mail" title="E-mail the corresponding author} ; Yu Wang^c ; ^{yu.wang@cchmc.org" class="auth_mail" title="E-mail the corresponding author} ; Nanhua Zhang^c ; ^{nanhua.zhang@cchmc.org" class="auth_mail" title="E-mail the corresponding author} ; John P. Clancy^a ; ^{john.clancy@cchmc.org" class="auth_mail" title="E-mail the corresponding author} ; Dennis Drotar^b ; ^{dennis.drotar@cchmc.org" class="auth_mail" title="E-mail the corresponding author}
• 关键词：BMI ; body mass index ; CF ; cystic fibrosis ; CFTR ; cystic fibrosis transmembrane conductance regulator ; EM ; electronic monitoring ; FEV1PP ; forced expiratory volume in 1  ; second percent predicted ; MEMS ; Medication Events Monitoring System ; MPR ; medication possession ratio ; SD ; standard deviation
• 刊名：Journal of Cystic Fibrosis
• 出版年：2015
• 出版时间：September 2015
• 年：2015
• 卷：14
• 期：5
• 页码：621-626
• 全文大小：443 K

文摘

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.

Methods

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.

Results

12 subjects (age 6–48 years; CFTR-G551D mutation) previously prescribed ivacaftor were monitored for a mean of 118 days. Overall adherence by EM was 61%(SD = 28%) and decreased over time. Median duration between doses was 16.9 hours (IQR 13.9–24.1 hours) 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).

Conclusions

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.