文章基本信息

标题：Defining medication adherence in individual patients
本地全文：下载
作者：Alan Morrison ; Melissa E Stauffer ; Anna S Kaufman 等
期刊名称：Patient Preference and Adherence
印刷版ISSN：1177-889X
电子版ISSN：1177-889X
出版年度：2015
卷号：9
页码：893-897
DOI：10.2147/PPA.S86249
出版社：Dove Medical Press Ltd
摘要：Background: The classification of patients as adherent or non-adherent to medications is typically based on an arbitrary threshold for the proportion of prescribed doses taken. Here, we define a patient as pharmacokinetically adherent if the serum drug levels resulting from his/her pattern of medication-taking behavior remained within the therapeutic range. Methods: We used pharmacokinetic modeling to calculate serum drug levels in patients whose patterns of dosing were recorded by a medication event monitoring system. Medication event monitoring system data were from a previously published study of seven psoriasis patients prescribed 40 mg subcutaneous adalimumab at 14-day intervals for 1 year. Daily serum concentrations of adalimumab were calculated and compared with a known therapeutic threshold. Results: None of the seven patients took adalimumab precisely every 14 days. Three patients who took adalimumab at intervals of 6–26 days could be classified as pharmacokinetically adherent, because their daily adalimumab serum concentration never fell below the therapeutic threshold. The four other patients, who took adalimumab at intervals of 7–93 days, could be classified as pharmacokinetically non-adherent, because their adalimumab serum concentration fell below the therapeutic threshold on 3.5%–71.3% of days. Conclusion: Patients with varying patterns of adalimumab dosing could be classified as pharmacokinetically adherent or non-adherent according to whether or not their serum drug concentrations remained within the therapeutic range.
关键词：pharmacokinetic adherence; drug therapy/utilization; drug administration schedule; patient compliance; adalimumab; pharmacokinetics