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Assessing the performance of group-based trajectory modeling method to discover different patterns of medication
Awa Diop1,2, Alind Gupta3, Sabrina Mueller4
1Core Clinical Sciences Inc., Vancouver, British Columbia, Canada.
Pharmaceutical Statistics
|February 8, 2024
Summary
Group-based trajectory modeling (GBTM) effectively captures complex medication adherence patterns, outperforming the proportion of days covered (PDC) and longitudinal K-means in a simulation study.
Area of Science:
- Health Services Research
- Biostatistics
- Pharmaceutical Sciences
Background:
- Medication adherence is crucial for patient outcomes and reducing mortality.
- The Pharmacy Quality Alliance (PQA) identifies medication adherence as a key quality indicator.
- Current adherence measurement methods, like proportion of days covered (PDC), have limitations in capturing dynamic patient behavior.
Purpose of the Study:
- To evaluate the efficacy of Group-based Trajectory Modeling (GBTM) in assessing medication adherence.
- To compare GBTM's performance against the proportion of days covered (PDC) and longitudinal K-means using simulation data.
- To demonstrate GBTM's ability to capture heterogeneity in treatment adherence patterns.
Main Methods:
- A simulation study was conducted using time-varying treatment data generated with quadratic functions and covariates.
- Three trajectory models were employed, incorporating 'cat's cradle' and 'rainbow' effects.
- Performance was assessed by comparing GBTM, PDC, and longitudinal K-means using metrics like absolute bias, variance, c-statistics, relative bias, and relative variance.
Main Results:
- Group-based trajectory modeling (GBTM) demonstrated superior performance in capturing diverse medication adherence patterns compared to PDC and longitudinal K-means.
- GBTM exhibited lower relative bias and variance across all simulated scenarios, even when models were misspecified.
- The study highlights GBTM's robustness in analyzing complex, dynamic adherence data.
Conclusions:
- Group-based trajectory modeling (GBTM) is a more effective method for assessing medication adherence than traditional approaches like PDC.
- GBTM's ability to capture heterogeneity and dynamic changes in adherence offers a more nuanced understanding of patient behavior.
- Further application of GBTM can improve medication use quality assessment and patient care strategies.
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