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      Adherencia terapéutica de ácido obeticólico: experiencia real utilizando sistemas de monitorización de medicación electrónicos Translated title: Medication adherence to obeticholic acid: a real-world experience using medication event monitoring systems

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          Abstract

          Resumen Objetivo: Diseñamos un estudio clínico para analizar los patrones de adherencia al ácido obeticólico, los factores que influyen en la adherencia y la posible correlación con la eficacia del tratamiento mediante el uso de MEMS® cap en la práctica clínica diaria. Método: Estudio observacional prospectivo multicéntrico de pacientes con colangitis biliar primaria. La adherencia se medirá mediante MEMS® cap, el recuento de comprimidos y se registrarán los resultados comunicados por el paciente durante 3 meses. La calidad de vida será autoinformada utilizando el Cuestionario de Enfermedad Hepática Crónica, el Cuestionario Europeo de Calidad de Vida en cinco dimensiones y la Escala de Intensidad del Picor. Conclusiones: Esperamos identificar si existe una relación entre la adherencia con la efectividad del tratamiento e identificar las causas de la falta de adherencia para poder introducir medidas para reducir su prevalencia.

          Translated abstract

          Abstract Objective: We designed a clinical study to analyze patterns of adherence to obeticholic acid, factors influencing the adherence and potential correlation with treatment efficacy by using MEMS® cap in practice daily. Method: A multicenter prospective observational study of patients with primary biliary cholangitis. Adherence will be measured by MEMS® cap, pill count, and patient-reported outcomes during 3 months. The quality of life will be self-reported using the Chronic Liver Disease Questionnaire test, European Quality of Life 5-Dimension Questionnaire test and Itch Severity Scale. Conclusions: We expect to clarify if there is correlation between adherence with treatment efficacy and to identify causes for poor compliance and introduce measures to reduce its prevalence.

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          Most cited references20

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          A new taxonomy for describing and defining adherence to medications.

          Interest in patient adherence has increased in recent years, with a growing literature that shows the pervasiveness of poor adherence to appropriately prescribed medications. However, four decades of adherence research has not resulted in uniformity in the terminology used to describe deviations from prescribed therapies. The aim of this review was to propose a new taxonomy, in which adherence to medications is conceptualized, based on behavioural and pharmacological science, and which will support quantifiable parameters. A systematic literature review was performed using MEDLINE, EMBASE, CINAHL, the Cochrane Library and PsycINFO from database inception to 1 April 2009. The objective was to identify the different conceptual approaches to adherence research. Definitions were analyzed according to time and methodological perspectives. A taxonomic approach was subsequently derived, evaluated and discussed with international experts. More than 10 different terms describing medication-taking behaviour were identified through the literature review, often with differing meanings. The conceptual foundation for a new, transparent taxonomy relies on three elements, which make a clear distinction between processes that describe actions through established routines ('Adherence to medications', 'Management of adherence') and the discipline that studies those processes ('Adherence-related sciences'). 'Adherence to medications' is the process by which patients take their medication as prescribed, further divided into three quantifiable phases: 'Initiation', 'Implementation' and 'Discontinuation'. In response to the proliferation of ambiguous or unquantifiable terms in the literature on medication adherence, this research has resulted in a new conceptual foundation for a transparent taxonomy. The terms and definitions are focused on promoting consistency and quantification in terminology and methods to aid in the conduct, analysis and interpretation of scientific studies of medication adherence. © 2012 The Authors. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society.
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            Medication compliance and persistence: terminology and definitions.

            The aim of the study is to provide guidance regarding the meaning and use of the terms "compliance" and "persistence" as they relate to the study of medication use. A literature review and debate on appropriate terminology and definitions were carried out. Medication compliance and medication persistence are two different constructs. Medication compliance (synonym: adherence) refers to the degree or extent of conformity to the recommendations about day-to-day treatment by the provider with respect to the timing, dosage, and frequency. It may be defined as "the extent to which a patient acts in accordance with the prescribed interval, and dose of a dosing regimen." Medication persistence refers to the act of continuing the treatment for the prescribed duration. It may be defined as "the duration of time from initiation to discontinuation of therapy." No overarching term combines these two distinct constructs. Providing specific definitions for compliance and persistence is important for sound quantitative expressions of patients' drug dosing histories and their explanatory power for clinical and economic events. Adoption of these definitions by health outcomes researchers will provide a consistent framework and lexicon for research.
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              Medication Adherence Measures: An Overview

              WHO reported that adherence among patients with chronic diseases averages only 50% in developed countries. This is recognized as a significant public health issue, since medication nonadherence leads to poor health outcomes and increased healthcare costs. Improving medication adherence is, therefore, crucial and revealed on many studies, suggesting interventions can improve medication adherence. One significant aspect of the strategies to improve medication adherence is to understand its magnitude. However, there is a lack of general guidance for researchers and healthcare professionals to choose the appropriate tools that can explore the extent of medication adherence and the reasons behind this problem in order to orchestrate subsequent interventions. This paper reviews both subjective and objective medication adherence measures, including direct measures, those involving secondary database analysis, electronic medication packaging (EMP) devices, pill count, and clinician assessments and self-report. Subjective measures generally provide explanations for patient's nonadherence whereas objective measures contribute to a more precise record of patient's medication-taking behavior. While choosing a suitable approach, researchers and healthcare professionals should balance the reliability and practicality, especially cost effectiveness, for their purpose. Meanwhile, because a perfect measure does not exist, a multimeasure approach seems to be the best solution currently.
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                Author and article information

                Journal
                fh
                Farmacia Hospitalaria
                Farm Hosp.
                Grupo Aula Médica (Toledo, Toledo, Spain )
                1130-6343
                2171-8695
                August 2022
                : 46
                : 4
                : 260-264
                Affiliations
                [1] Santiago de Compostela orgnameHospital Clínico Universitario de Santiago de Compostela orgdiv1Servicio de Farmacia España
                Article
                S1130-63432022000400009 S1130-6343(22)04600400009
                10.7399/fh.11824
                20d93be5-31ba-4bdb-9975-347c4e94782d

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 23 December 2021
                : 16 August 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 20, Pages: 5
                Product

                SciELO Spain

                Categories
                Protocolos

                Liver Cirrhosis, Biliary,Medication adherence,Medication event monitoring systems,Obeticholic acid,Quality of life,Adherencia a la medicación,Sistemas de monitorización de medicación electrónicos,Ácido obeticólico,Colangitis biliar primaria,Calidad de vida

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