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      Comparison of Different Strategies to Measure Medication Adherence via Claims Data in Patients With Chronic Heart Failure

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          Abstract

          Medication adherence correlates with morbidity and mortality in patients with chronic heart failure ( CHF), but is difficult to assess. We conducted a retrospective methodological cohort study in 3,808 CHF patients, calculating adherence as proportion of days covered ( PDC) utilizing claims data from 2010 to 2015. We aimed to compare different parameters’ influence on the PDC of elderly CHF patients exemplifying a complex chronic disease. Investigated parameters were the assumed prescribed daily dose ( PDD), stockpiling, and periods of hospital stay. Thereby, we investigated a new approach using the PDD assigned to different percentiles. The different dose assumptions had the biggest influence on the PDC, with variations from 41.9% to 83.7%. Stockpiling and hospital stays increased the values slightly. These results queries that a reliable PDC can be calculated with an assumed PDD. Hence, results based on an assumed PDD have to be interpreted carefully and should be presented with sensitivity analyses to show the PDC's possible range.

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          Epidemiology and one-year outcomes in patients with chronic heart failure and preserved, mid-range and reduced ejection fraction: an analysis of the ESC Heart Failure Long-Term Registry.

          Ovidiu Chioncel, Mitja Lainscak, Petar Seferovic … (2018)
          The objectives of the present study were to describe epidemiology and outcomes in ambulatory heart failure (HF) patients stratified by left ventricular ejection fraction (LVEF) and to identify predictors for mortality at 1 year in each group.
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            Epidemiology of heart failure: the prevalence of heart failure and ventricular dysfunction in older adults over time. A systematic review.

            Evelien E S van Riet, Arno Hoes, Kim Wagenaar … (2016)
            The 'epidemic' of heart failure seems to be changing, but precise prevalence estimates of heart failure and left ventricular dysfunction (LVD) in older adults, based on adequate echocardiographic assessment, are scarce. Systematic reviews including recent studies on the prevalence of heart failure and LVD are lacking. We aimed to assess the trends in the prevalence of LVD, and heart failure with reduced (HFrEF) and preserved ejection fraction (HFpEF) in the older population at large. A systematic electronic search of the databases Medline and Embase was performed. Studies that reported prevalence estimates in community-dwelling people ≥60 years old were included if echocardiography was used to establish the diagnosis. In total, 28 articles from 25 different study populations were included. The median prevalence of systolic and 'isolated' diastolic LVD was 5.5% (range 3.3-9.2%) and 36.0% (range 15.8-52.8%), respectively. A peak in systolic dysfunction prevalence seems to have occurred between 1995 and 2000. 'All type' heart failure had a median prevalence rate of 11.8% (range 4.7-13.3%), with fairly stable rates in the last decade and with HFpEF being more common than HFrEF [median prevalence 4.9% (range 3.8-7.4%) and 3.3% (range 2.4-5.8%), respectively]. Both LVD and heart failure remain common in the older population at large. The prevalence of diastolic dysfunction is on the rise and currently higher than that of systolic dysfunction. The prevalence of the latter seems to have decreased in the 21st century.
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              A checklist for medication compliance and persistence studies using retrospective databases.

              Andrew M Peterson, David P Nau, Joyce Cramer … (2015)
              The increasing number of retrospective database studies related to medication compliance and persistence (C&P), and the inherent variability within each, has created a need for improvement in the quality and consistency of medication C&P research. This article stems from the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) efforts to develop a checklist of items that should be either included, or at least considered, when a retrospective database analysis of medication compliance or persistence is undertaken. This consensus document outlines a systematic approach to designing or reviewing retrospective database studies of medication C&P. Included in this article are discussions on data sources, measures of C&P, results reporting, and even conflict of interests. If followed, this checklist should improve the consistency and quality of C&P analyses, which in turn will help providers and payers understand the impact of C&P on health outcomes.
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                Author and article information

                Contributors
                Martin Schulz: m.schulz@abda.de
                Journal
                Journal ID (nlm-ta): Clin Pharmacol Ther
                Journal ID (iso-abbrev): Clin. Pharmacol. Ther
                Journal ID (doi): 10.1002/(ISSN)1532-6535
                Journal ID (publisher-id): CPT
                Title: Clinical Pharmacology and Therapeutics
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Print): 0009-9236
                ISSN (Electronic): 1532-6535
                Publication date (Electronic): 12 March 2019
                Publication date (Print): July 2019
                Publication date PMC-release: 12 March 2019
                Volume: 106
                Issue: 1 , Real‐World Data: Real‐World Evidence ( doiID: 10.1002/cpt.2019.106.issue-1 )
                Pages: 211-218
                Affiliations
                [ 1 ] PMV research group Faculty of Medicine and University Hospital Cologne University of Cologne Cologne Germany
                [ 2 ] Department of Medicine ABDA – Federal Union of German Associations of Pharmacists Berlin Germany
                [ 3 ] Department of Cardiology University Hospital Leipzig University Leipzig Germany
                [ 4 ] Department of Clinical Pharmacy and Biochemistry Institute of Pharmacy Freie Universität Berlin Berlin Germany
                Author notes
                [*] [* ]Correspondence: Martin Schulz ( m.schulz@ 123456abda.de )
                Article
                Publisher ID: CPT1378
                DOI: 10.1002/cpt.1378
                PMC ID: 6617982
                PubMed ID: 30697693
                SO-VID: f6fa26bc-f80e-4978-bc69-f74b0396546c
                Copyright © © 2019 The Authors Clinical Pharmacology & Therapeutics published by Wiley Periodicals, Inc. on behalf of American Society for Clinical Pharmacology and Therapeutics.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                Date received : 30 August 2018
                Date accepted : 08 January 2019
                Page count
                Figures: 2, Tables: 2, Pages: 8, Words: 6768
                Categories
                Subject: Article
                Subject: Research
                Subject: Articles
                Custom metadata
                source-schema-version-number 2.0
                component-id cpt1378
                cover-date July 2019
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.5 mode:remove_FC converted:10.07.2019

                ScienceOpen disciplines: Pharmacology & Pharmaceutical medicine
                Data availability:
                ScienceOpen disciplines: Pharmacology & Pharmaceutical medicine

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