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Medication adherence in patients with nontuberculous mycobacterial disease
Arthur Lemson1, Fleur Dijkhuizen1, Ralf Stemkens2
1Department of Pulmonary Diseases, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, the Netherlands.
Objectives:
We aimed to measure and understand medication adherence in patients with nontuberculous mycobacterial (NTM) disease.
Methods:
We enrolled adults with NTM disease receiving antimycobacterial treatment at Radboudumc, the Netherlands. Demographics and treatment outcomes were recorded, and medication adherence was assessed repeatedly. Adherence was measured using the Proportion of Days Covered (PDC) at 6 and 12 months, calculated from pharmacy records, and the 5-item Medication Adherence Report Scale (MARS-5). The Beliefs about Medicines Questionnaire (BMQ) explored reasons for (non)adherence.
Results:
Sixty-one participants were enrolled, with a mean age of 63.2 (±12.9) years. Forty-one (67 %) had pulmonary, and 20 (33 %) extrapulmonary NTM disease, with M. avium complex being the most prevalent species (n = 38; 62 %). One or more adverse effects occurred in 56/61 (92 %) participants. A favorable response was seen in 34/49 (69 %) and 25/29 (86 %) participants at 6 and 12 months, respectively. The median PDC was 100 % (IQR, 99-100 %) at both timepoints, and the MARS-5 remained 5 out of 5 throughout treatment, indicating high adherence. Participants' beliefs about the necessity of NTM treatment, as assessed in the BMQ, consistently outweighed concerns.
Conclusions:
Medication adherence was high throughout the first year of NTM treatment, likely due to the perceived necessity of treatment and regular follow-up at our reference clinic.
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