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      Predictors of duloxetine adherence and persistence in patients with fibromyalgia

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          Abstract

          Objectives

          Adherence to medication for the treatment of fibromyalgia (FM) is predictive of lower overall health-care costs, and thus a lower burden on both patients and providers. The objectives of this study were to examine the predictors of adherence to and persistence with duloxetine therapy among commercially insured FM patients, and to identify subgroups of patients with high duloxetine persistence and adherence.

          Study design

          This cross-sectional, retrospective study analyzed medical and pharmacy records over 1 year for patients in the US aged 18–64 years with FM who initiated (no prior 90-day use) duloxetine treatment in 2008.

          Methods

          Adherence to duloxetine was measured by medication possession ratio (MPR), with high adherence defined as MPR ≥ 0.8. Persistence was defined as the duration of therapy from the index date to the earliest of: the ending date of the last prescription, the date of the first gap of >15 days between prescriptions, or the end of the study period (12 months). Demographic and clinical predictors of adherence were examined via multiple logistic regression (MLR), and subgroups of duloxetine-persistent and -adherent patients were identified using classification and regression trees (CART).

          Results

          Among 4660 duloxetine patients, 33% achieved high adherence. Factors associated with high adherence from MLR included older age, North Central and Northeast regions, prior venlafaxine, pregabalin, selective serotonin reuptake inhibitor (SSRI), or other antidepressant use, or comorbid dyslipidemia or osteoarthritis (all P < 0.05). CART analysis revealed that patients with prior antidepressant use, aged ≥46, or prior osteoarthritis had higher MPR (all P < 0.05), and patients aged ≥45 with a history of SSRI, venlafaxine, or anticonvulsant use had longer duration of therapy (all P < 0.05).

          Conclusions

          Patients with high adherence to and persistence with duloxetine were significantly older and had prior antidepressant use.

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          Author and article information

          Journal
          J Pain Res
          J Pain Res
          Journal of Pain Research
          Dove Medical Press
          1178-7090
          2012
          22 June 2012
          : 5
          : 193-201
          Affiliations
          Eli Lilly and Company, Indianapolis, IN, USA
          Author notes
          Correspondence: Zhanglin Cui, Eli Lilly and Company, Lilly Corporate Center, DC 1079, Indianapolis, IN 46285, USA, Tel +1 317 651 5935, Fax +1 317 277 6097, Email cui_zhanglin@ 123456lilly.com
          Article
          jpr-5-193
          10.2147/JPR.S31800
          3392711
          22792005
          © 2012 Cui et al, publisher and licensee Dove Medical Press Ltd

          This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

          Categories
          Original Research

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