Adherence and Integrated Care

Last uploaded: May 13, 2019
Preferred Name

Persistence

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Persistence (term first introduced in 2001 [1]) refers to the period of time from the initiation phase of prescribed pharmacological treatment to the last dose taken. That is, it immediately precedes the third and final phase of medication adherence [1]. In chronic treatments and although there is no total abandonment of medication, persistence can also be measured since the calculation is made between the start of treatment or a temporary point of chronic treatment and the end of the observation period. Persistence analyses in this case should include a permitted time limit for medication withdrawal (which is calculated based on the pharmacokinetics of the medication) between prescriptions. If this time limit is exceeded, the patient is not persistent, whereas if the time limits allowed between different prescriptions are not exceeded, the patient is considered persistent [2]. Using information obtained from secondary databases, it is possible to obtain the Proportion of Covered Days (PDC) as the number of days with available medications divided by the number of days in the specified time interval [3] as a measure of persistence [4]. It is also possible to measure persistence by considering it a dichotomous variable and by means of a cut-off value corresponding to the maximum time period during which the patient may not take his dose without being considered non-persistent [2]. Measuring persistence in medication replacement (PR) is one of the two parameters (the other is adherence to daily medication) that some authors [5,6] consider necessary to assess the patient's therapeutic compliance (adherence to medication). PR is characterized by the number of consecutive monthly replacements over a longer period (usually one year) for chronic illnesses requiring prolonged medication [7]. [1] Vrijens, B., De Geest, S., Hughes, D. A., Przemyslaw, K., Demonceau, J., Ruppar, T., … Urquhart, J. (2012). A new taxonomy for describing and defining adherence to medications. British Journal of Clinical Pharmacology, 73(5), 691–705. https://doi.org/10.1111/j.1365-2125.2012.04167.x [2] López González, S. (2017). Una revisión sistemática de la adherencia al tratamiento antihipertensivo y de las intervenciones destinadas a mejorarla. Universidad de Cantabria. [3] Capoccia, K., Odegard, P. S., & Letassy, N. (2016). Medication Adherence With Diabetes Medication: A Systematic Review of the Literature. The Diabetes Educator, 42(1), 34–71. https://doi.org/10.1177/0145721715619038 [4] Lam, W. Y., & Fresco, P. (2015). Medication Adherence Measures: An Overview. BioMed Research International. e217047. https://doi.org/10.1155/2015/217047 [5] García-Jiménez, E., Amariles, P., Machuca, M., Parras-Martín, M., Espejo-Guerrero JD, Faus MJ. (2008). Incumplimiento, problemas relacionados con los medicamentos y resultados negativos asociados a la medicación: causas y resultados en el seguimiento farmacoterapéutico. Ars Pharm, 49(2), 145–157. [6] Richard W, Grant MD, Kathleen M, O’Leary BA, Jeffrey B, Weilburg MD, et al. (2004). Impact of concurrent medication use on statin adherence and refill persistence. Arch Intern Med. 164: 2.343-8 [7] Rodríguez Chamorro, M. Á., García-Jiménez, E., Gil, A. B., Chamorro, A. R., Pérez Merino, E. M., Faus Dáder, M. J., Martínez Martínez, F. (2009). Herramientas para identificar el incumplimiento farmacoterapéutico desde la farmacia comunitaria Tools for the identification by community pharmacies of pharmacotherapeutic non-compliance. Pharmaceutical Care España, 11(4), 183–191. 130965009 | Persistence | Persistence ispart of the EMERGE Medication Adherence Guide (Item 3b) [1] Grounded, A. R. G. E. (2018). ESPACOMP Medication Adherence Reporting Guideline (EMERGE). Ann Intern Med, 169, 30-35.

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http://www.semanticweb.org/parracarlos/ontologies/2019/3/untitled-ontology-31#Persistence

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Persistence (term first introduced in 2001 [1]) refers to the period of time from the initiation phase of prescribed pharmacological treatment to the last dose taken. That is, it immediately precedes the third and final phase of medication adherence [1]. In chronic treatments and although there is no total abandonment of medication, persistence can also be measured since the calculation is made between the start of treatment or a temporary point of chronic treatment and the end of the observation period. Persistence analyses in this case should include a permitted time limit for medication withdrawal (which is calculated based on the pharmacokinetics of the medication) between prescriptions. If this time limit is exceeded, the patient is not persistent, whereas if the time limits allowed between different prescriptions are not exceeded, the patient is considered persistent [2]. Using information obtained from secondary databases, it is possible to obtain the Proportion of Covered Days (PDC) as the number of days with available medications divided by the number of days in the specified time interval [3] as a measure of persistence [4]. It is also possible to measure persistence by considering it a dichotomous variable and by means of a cut-off value corresponding to the maximum time period during which the patient may not take his dose without being considered non-persistent [2]. Measuring persistence in medication replacement (PR) is one of the two parameters (the other is adherence to daily medication) that some authors [5,6] consider necessary to assess the patient's therapeutic compliance (adherence to medication). PR is characterized by the number of consecutive monthly replacements over a longer period (usually one year) for chronic illnesses requiring prolonged medication [7]. [1] Vrijens, B., De Geest, S., Hughes, D. A., Przemyslaw, K., Demonceau, J., Ruppar, T., … Urquhart, J. (2012). A new taxonomy for describing and defining adherence to medications. British Journal of Clinical Pharmacology, 73(5), 691–705. https://doi.org/10.1111/j.1365-2125.2012.04167.x [2] López González, S. (2017). Una revisión sistemática de la adherencia al tratamiento antihipertensivo y de las intervenciones destinadas a mejorarla. Universidad de Cantabria. [3] Capoccia, K., Odegard, P. S., & Letassy, N. (2016). Medication Adherence With Diabetes Medication: A Systematic Review of the Literature. The Diabetes Educator, 42(1), 34–71. https://doi.org/10.1177/0145721715619038 [4] Lam, W. Y., & Fresco, P. (2015). Medication Adherence Measures: An Overview. BioMed Research International. e217047. https://doi.org/10.1155/2015/217047 [5] García-Jiménez, E., Amariles, P., Machuca, M., Parras-Martín, M., Espejo-Guerrero JD, Faus MJ. (2008). Incumplimiento, problemas relacionados con los medicamentos y resultados negativos asociados a la medicación: causas y resultados en el seguimiento farmacoterapéutico. Ars Pharm, 49(2), 145–157. [6] Richard W, Grant MD, Kathleen M, O’Leary BA, Jeffrey B, Weilburg MD, et al. (2004). Impact of concurrent medication use on statin adherence and refill persistence. Arch Intern Med. 164: 2.343-8 [7] Rodríguez Chamorro, M. Á., García-Jiménez, E., Gil, A. B., Chamorro, A. R., Pérez Merino, E. M., Faus Dáder, M. J., Martínez Martínez, F. (2009). Herramientas para identificar el incumplimiento farmacoterapéutico desde la farmacia comunitaria Tools for the identification by community pharmacies of pharmacotherapeutic non-compliance. Pharmaceutical Care España, 11(4), 183–191.

130965009 | Persistence |

Persistence ispart of the EMERGE Medication Adherence Guide (Item 3b) [1] Grounded, A. R. G. E. (2018). ESPACOMP Medication Adherence Reporting Guideline (EMERGE). Ann Intern Med, 169, 30-35.

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Persistence

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Persistence

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130965009

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http://www.semanticweb.org/parracarlos/ontologies/2019/3/untitled-ontology-31#Pattern

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