ArticleDrugs in R&D2017
The Adherence Rate Threshold is Drug Specific.
Article in Drugs in R&D, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Content Validation of a Medication Adherence Risk Score (MARS) for Mortality Risk Prediction: A Delphi Consensus.Clinical pharmacology and therapeutics · 2026Pooled it
- A systematic review of medication adherence and mortality in chronic disease: Implications for clinical guidelines and policy.British journal of clinical pharmacology · 2026Pooled it
- Healthcare for individuals with schizophrenia in Taiwan: 10-year national trend analysis.BJPsych open · 2025Article
- Absorbing Markov chain model of PrEP drug adherence to estimate adherence decay rate and probability distribution in clinical trials.Journal of theoretical biology · 2025Article
- Beyond prescriptions: chronic medication adherence predicts mortality risk in a large-scale cohort study.Frontiers in pharmacology · 2025Article
- Association Between Oral Anticoagulant Adherence and Serious Clinical Outcomes in Patients With Atrial Fibrillation: A Long-Term Retrospective Cohort Study.Journal of the American Heart Association · 2024Observational
- Imatinib Adherence and Persistence in Patients with Chronic Myeloid Leukemia in Belgium: Evidence from Real-World Data.Patient preference and adherence · 2024Article
- Leveraging mathematical modeling to analyze nonadherence for hydroxyurea therapy in sickle cell disease.CPT: pharmacometrics & systems pharmacology · 2023Article
- Medication Adherence Measurement Methods in Registration Trials Supporting the Approval of New Medicines: A Cross-Sectional Analysis of Centralized Procedures in the European Union 2010-2020.Clinical pharmacology and therapeutics · 2022Article
- A pharmacokinetic and pharmacodynamic analysis of drug forgiveness.Journal of pharmacokinetics and pharmacodynamics · 2022Article
- Effect of Missed Doses on the Therapeutic Effect of Methotrexate for Rheumatoid Arthritis: A Pharmacokinetic Modeling Study.Open access rheumatology : research and reviews · 2021Article
- Patterns of non-adherence to oral antiretroviral medication: frequencies of consecutively missed doses.Patient preference and adherence · 2019Article
- Acceptable medication non-adherence: A crowdsourcing study among French physicians for commonly prescribed medications.PloS one · 2018Article
- Estimating Adherence Based on Prescription or Dispensation Information: Impact on Thresholds and Outcomes. A Real-World Study With Atrial Fibrillation Patients Treated With Oral Anticoagulants in Spain.Frontiers in pharmacology · 2018Article
- A Systematic Review of Medication Adherence Thresholds Dependent of Clinical Outcomes.Frontiers in pharmacology · 2018Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPatient adherence to a medication regimen is usually expressed as an adherence rate, defined as the proportion of prescribed doses actually taken. An adherence rate threshold, above which the therapeutic effect is maintained, is typically assigned an arbitrary value, commonly 0.8.
objectiveHere, we determined the value of the adherence rate threshold objectively in different drugs of the same class, using statins as an example.
methodsWe used pharmacokinetic/pharmacodynamic (PK/PD) modeling to predict serum levels of low-density lipoprotein cholesterol (LDL-C) in patients taking simvastatin 20 mg or atorvastatin 5 mg once daily for 30 days. LDL-C reduction was modeled for adherence rates of 1.0, 0.8, 0.6, 0.4, and 0.2. The results were expressed as the percentage of time spent at the LDL-C goal (< 70 mg/dL). The adherence rate threshold was defined as the minimum adherence rate that resulted in the same amount of time at goal as perfect adherence (i.e., a rate of 1.0).
resultsFor simvastatin, an adherence rate of 0.8 resulted in a significant decrease in time at the LDL-C goal compared to perfect adherence (54.8% versus 85.1%; P < 0.001), and rates < 0.8 resulted in progressively less time at goal. For atorvastatin, the rates of 0.8 and 0.6 resulted in essentially the same amount of time at goal as perfect adherence (87.8% and 87.7%, respectively, versus 88.1%; P > 0.05 for both), with less time at goal only occurring at rates ≤ 0.4 (P < 0.001). Thus, the adherence rate thresholds are > 0.8 for simvastatin and between 0.4 and 0.6 for atorvastatin.
conclusionThese results indicate that a value of 0.8 cannot be applied universally.
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