Discontinuation, persistence and adherence to subcutaneous biologics delivered via a homecare route to Scottish adults with rheumatic diseases: a retrospective study.
Adult
Antirheumatic Agents
/ therapeutic use
Biological Products
/ therapeutic use
Drug Resistance
Drug Substitution
/ statistics & numerical data
Drug Utilization Review
/ methods
Female
Humans
Injections, Subcutaneous
Male
Medication Adherence
/ statistics & numerical data
Middle Aged
Musculoskeletal Diseases
/ drug therapy
Retrospective Studies
Rheumatic Diseases
/ drug therapy
Scotland
/ epidemiology
adherence
ankylosing spondylitis
biologics
persistence
psoriatic arthritis
rheumatoid arthritis
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
04 09 2019
04 09 2019
Historique:
entrez:
7
9
2019
pubmed:
7
9
2019
medline:
26
9
2020
Statut:
epublish
Résumé
To understand patterns of subcutaneous (SC) biologics use over time in adults with inflammatory rheumatic musculoskeletal diseases receiving a homecare delivery service. Retrospective cohort. Patients in secondary care receiving SC biologics in the largest Scottish Health Board. A new bespoke cohort was created from routine data gathered as part of a health board Homecare Service Database. Patients over 18 years who received a supply of SC biologic from January 2012 to May 2015 with a diagnosis for rheumatoid arthritis (RA), psoriatic arthritis (PsA) or ankylosing spondylitis (AS) were included. A standardised framework was applied by measuring discontinuation rates, persistence using Kaplan-Meier analysis and Cox regression and adherence using medication refill adherence (MRA) and compliance rate (CR). 751 patients were identified (AS: 105, PsA: 227, RA: 419) of whom 89.3% had more than one biologic delivery (median days' follow-up: AS: 494; PsA: 544; RA: 529) and 83.2% did not switch biologic. For all conditions, approximately half were persistent on their index biologic (52% AS, 54% PsA, 48%RA). Of patients who discontinued treatment, the majority reinitiated with the same biologic (19% AS, 18% PsA and 21% RA). Overall adherence during the period of treatment was over 80% when calculated using MRA (median %MRA: AS: 84.0%, PsA: 85.0%, RA: 82.4%) or CR (median %CR: AS: 96.6%, PsA: 97%, RA: 96.6%). Use of linked routine data is a sustainable pathway to enable ongoing evaluation of biologics use. A more consistent approach to studying use (discontinuation, persistence and adherence metrics) should be adopted to enable comparability of studies.
Identifiants
pubmed: 31488467
pii: bmjopen-2018-027059
doi: 10.1136/bmjopen-2018-027059
pmc: PMC6731860
doi:
Substances chimiques
Antirheumatic Agents
0
Biological Products
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e027059Subventions
Organisme : Arthritis Research UK
Pays : United Kingdom
Organisme : British Heart Foundation
Pays : United Kingdom
Organisme : Cancer Research UK
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/K007017/1
Pays : United Kingdom
Organisme : Chief Scientist Office
Pays : United Kingdom
Organisme : Wellcome Trust
Pays : United Kingdom
Informations de copyright
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: SS has received honoraria from Janssen, Novartis, AbbVie, Pfizer, UCB, Celgene and Boehringer-Ingelheim, and research funding from UCB, Celgene, Boehringer-Ingelheim, BMS and Pfizer.
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