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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Lafata, Jennifer Elston Cerghet, Mirela Dobie, Elizabeth Schultz, Lonni Tunceli, Kaan Reuther, Jacqueline Elias, Stanton |
| Spatial Coverage | Michigan |
| Description | Country affiliation: United States Author Affiliation: Lafata JE ( Center for Health Services Research, Henry Ford Hospital, Detroit, MI 48202, USA. jlafata1@hfhs.org) |
| Abstract | OBJECTIVES: To measure disease-modifying agent adherence and persistence among patients with multiple sclerosis (MS). DESIGN: Retrospective cohort study. SETTING: Multispecialty, salaried group practice in southeast Michigan, between June 1, 2004, and June 30, 2006. PATIENTS: 224 insured adult patients with relapsing remitting MS with an outpatient visit. MAIN OUTCOME MEASURES: Medical record-documented receipt of medication recommendation and prescription. Pharmacy claims data-derived measures of dispensing and among patients with two or more dispensings, medication possession ratios (MPRs), and proportion of gap days were estimated. Among those initiating agent use, persistence was estimated. RESULTS: Mean cohort age was 47.6 years, while 77% of participants were women and 39% were black. Of patients, 81.8% had a recommendation for a disease-modifying agent, 75.0% had a prescription, and 66.5% had two or more dispensings. Among those with two or more dispensings, mean MPR between the first and last dispensing date was 83.8% (95% CI 80.8-86.8), while mean MPR for the entire 24-month period was 68.0% (64.4-71.7). MPR for the 24-month period decreased with increasing drug copayments and was lower among black patients, while MPR between the first and last dispensing date increased with increasing age. Among those initiating therapy, 43% were nonpersistent with medications within 14 months. CONCLUSION: Medication adherence and persistence among patients with relapsing remitting MS is far from monolithic. Measuring medication adherence and persistence among defined populations is useful for understanding the relationship between medication use and outcomes in practice and for targeting patients and programs to improve medication adherence. |
| File Format | HTM / HTML |
| ISSN | 15443191 |
| Issue Number | 6 |
| Volume Number | 48 |
| e-ISSN | 15443450 |
| Journal | Journal of the American Pharmacists Association |
| Language | English |
| Publisher | Elsevier |
| Publisher Date | 2008-11-01 |
| Publisher Place | United States |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Discipline Pharmacology Immunologic Factors Therapeutic Use Medication Adherence Multiple Sclerosis, Relapsing-remitting Drug Therapy Adult African Americans Statistics & Numerical Data Age Factors Ambulatory Care Cohort Studies Cost Sharing Economics Female Humans Insurance, Pharmaceutical Services Male Michigan Epidemiology Middle Aged Retrospective Studies Time Factors Journal Article Research Support, Non-u.s. Gov't |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pharmacology (nursing) Pharmacology Pharmacy |
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