Improving the accuracy of medication adherence measures using linked prescription and dispensation data: findings from the ESOSVAL cohort of patients treated with osteoporosis drugs

Objective: We compare estimates of proportion of days covered (PDC) based on dispensation-only data versus linked prescription and dispensation information, and we analyse their differences in a real-world cohort of patients with osteoporosis.Methods: Prospective cohort study. We compared four alter...

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Detalles Bibliográficos
Autores: Garcia-Sempere, Anibal, Hurtado, Isabel, Sanfelix-Genoves, Jose, Rodriguez-Bernal, Clara, Peiro, Salvador, Sanfelix-Gimeno, Gabriel
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p3406
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/3406
Access Level:acceso abierto
Palabra clave:Proportion of days covered
medication adherence
prescription data
dispensation data
methods
real-world data
Descripción
Sumario:Objective: We compare estimates of proportion of days covered (PDC) based on dispensation-only data versus linked prescription and dispensation information, and we analyse their differences in a real-world cohort of patients with osteoporosis.Methods: Prospective cohort study. We compared four alternative measures of PDC, using dispensation-only data: a) with a fixed assessment interval; b) censoring the assessment interval at the moment of the last refill; and using linked prescription and dispensation data: c) considering a minimum prescription gap of three months to interpret interruption by the physician; and d) considering any prescription gap.Results: The mean PDC at 12months for new users was 63.1% using dispensation-only data and a fixed interval, 86.0% using dispensation-only data and a last-refill interval, 81% using linked dispensation and prescription data and censoring any period without prescription, and 78.3% when using linked prescription and dispensation data and censoring periods of at least 3months. For experienced users, the figures were 80.0%, 88.9%, 83% and 81%, respectively. Overall, dispensation-based measures presented issues of patient misclassification.Conclusions: Linked prescription and dispensation data allows for more precise PDC estimates than dispensation-only data, as both primary non-adherence and early non-adherence periods, and fully non-adherent patients, are all identified and accounted for.