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Evaluation of adherence to antipsychotics: A real-world data study using four different dosing assumptions
Marina Fuente-Moreno1,2,3, Alexandra L Dima1,4, Maria Rubio-Valera1,4
1Health Technology Assessment in Primary Care and Mental Health (PRISMA) Research Group, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.
British Journal of Clinical Pharmacology
|March 18, 2024
Summary
Dosing inconsistencies are common in antipsychotic prescriptions. While most strategies yielded similar adherence estimates, selecting the highest dose may offer a more accurate measure for antipsychotic treatment adherence.
Area of Science:
- Pharmacology and Pharmacoepidemiology
- Psychiatric Pharmacy Practice
- Medication Adherence Research
Background:
- Antipsychotic treatment adherence is crucial for managing chronic mental health conditions.
- Prescription data often contains dosing inconsistencies, complicating adherence assessment.
- Understanding these inconsistencies is vital for accurate patient care and treatment outcomes.
Purpose of the Study:
- To evaluate the frequency of dosing inconsistencies in antipsychotic prescriptions.
- To assess the impact of four different dosing assumption strategies on adherence estimates.
- To identify the most accurate method for estimating adherence in antipsychotic treatment.
Main Methods:
- Retrospective cohort study linking prescription and dispensing data (2015-2019) in Catalonia, Spain.
- Analysis of adult patients with at least one antipsychotic prescription.
- Four strategies for handling overlapping prescriptions were compared: minimum dose, latest dose, highest dose, and all doses; adherence measured by Continuous Medication Availability.
Main Results:
- Over 76% of 277,324 prescriptions overlapped, with 40% having different dosing instructions.
- Mean adherence estimates were similar across strategies (57-60%).
- A higher proportion of patients achieved ≥90% adherence with strategies other than 'all doses' (35% vs. 28%).
Conclusions:
- High prevalence of overlapping antipsychotic prescriptions exists.
- The chosen dosing strategy had a limited impact on overall adherence estimates.
- Selecting the highest dose in overlapping periods may provide a more accurate adherence estimate for antipsychotic treatment, considering prescription practices.
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