TY - JOUR
T1 - Medication adherence in older people with rheumatoid arthritis is lower according to electronic monitoring than according to pill count
AU - Hartman, L
AU - Cutolo, M.
AU - Bos, Reinhard
AU - Opris-Belinski, D.
AU - Kok, Marc R
AU - Griep-Wentink, Hanneke R. M.
AU - Klaasen, R.
AU - Allaart, Cornelia F.
AU - Bruyn, G.A.W.
AU - Raterman, HG
AU - Voshaar, Marieke
AU - Gomes, Nuno
AU - Pinto, Rui M.A.
AU - Klausch, LT
AU - Lems, WF
AU - Boers, M
N1 - Publisher Copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology.
PY - 2021/11/3
Y1 - 2021/11/3
N2 - OBJECTIVES: Suboptimal medication adherence is a serious problem in the treatment of chronic inflammatory diseases. To measure medication adherence, electronic monitoring is regarded as superior to pill count. GLORIA is an ongoing two-year trial on the addition of low-dose (5 mg/d) prednisolone or placebo to standard care in older people (65+ years) with RA. During the entire trial, adherence is measured with electronic caps, and with pill counts. The objective is to describe medication adherence patterns, and to compare the adherence results of the two methods. METHODS: The recorded adherence patterns of patients (blinded for treatment group) were classified according to descriptive categories. The cutoff for good adherence was set at 80% of prescribed pills taken. RESULTS: Trial inclusion closed in 2018 at 451 patients, but trial follow-up is ongoing; the current dataset contains adherence data of 371 patients. Mean number of recorded 90-day periods per patient was 4 (range 1-8). Based on pill count over all periods, 90% of the patients had good adherence; based on cap data, only 20%. Cap data classified 30% of patients as non-user (<20% of days an opening) and 40% as irregular user (different adherence patterns, in or between periods). CONCLUSION: In our trial of older people with RA, the majority appeared to be adherent to medication according to pill count. Results from caps conflicted with those of pill counts, with patterns suggesting patients did not use the bottle for daily dispensing, despite specific advice to do so. TRIAL REGISTRATION: NCT02585258. ClinicalTrials.gov (https://www.clinicaltrials.gov/).
AB - OBJECTIVES: Suboptimal medication adherence is a serious problem in the treatment of chronic inflammatory diseases. To measure medication adherence, electronic monitoring is regarded as superior to pill count. GLORIA is an ongoing two-year trial on the addition of low-dose (5 mg/d) prednisolone or placebo to standard care in older people (65+ years) with RA. During the entire trial, adherence is measured with electronic caps, and with pill counts. The objective is to describe medication adherence patterns, and to compare the adherence results of the two methods. METHODS: The recorded adherence patterns of patients (blinded for treatment group) were classified according to descriptive categories. The cutoff for good adherence was set at 80% of prescribed pills taken. RESULTS: Trial inclusion closed in 2018 at 451 patients, but trial follow-up is ongoing; the current dataset contains adherence data of 371 patients. Mean number of recorded 90-day periods per patient was 4 (range 1-8). Based on pill count over all periods, 90% of the patients had good adherence; based on cap data, only 20%. Cap data classified 30% of patients as non-user (<20% of days an opening) and 40% as irregular user (different adherence patterns, in or between periods). CONCLUSION: In our trial of older people with RA, the majority appeared to be adherent to medication according to pill count. Results from caps conflicted with those of pill counts, with patterns suggesting patients did not use the bottle for daily dispensing, despite specific advice to do so. TRIAL REGISTRATION: NCT02585258. ClinicalTrials.gov (https://www.clinicaltrials.gov/).
KW - electronic monitoring
KW - glucocorticoids
KW - medication adherence
KW - pill count
KW - rheumatoid arthritis
UR - http://www.scopus.com/inward/record.url?scp=85121940649&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/rheumatology/keab207
DO - https://doi.org/10.1093/rheumatology/keab207
M3 - Article
C2 - 33682887
SN - 1462-0324
VL - 60
SP - 5239
EP - 5246
JO - Rheumatology (Oxford, England)
JF - Rheumatology (Oxford, England)
IS - 11
ER -