Evidence map›Paper›PMID 29725982›Full record

ArticleAdvances in therapy2018

Medication Adherence Patterns Among Patients with Multiple Serious Mental and Physical Illnesses.

Joanna P MacEwan, Alison R Silverstein, Jason Shafrin, Darius N Lakdawalla, Ainslie Hatch, Felicia M Forma

Abstract read
In one paragraph

Article in Advances in therapy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Medication Adherence Trajectories: A Systematic Literature Review.Journal of managed care & specialty pharmacy · 2020
    Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Joanna P MacEwanPrecision Health Economics, 11100 Santa Monica Blvd, Suite 500, Los Angeles, CA, 90025, USA. Joanna.macewan@precisionhealtheconomics.com.
Alison R SilversteinPrecision Health Economics, 11100 Santa Monica Blvd, Suite 500, Los Angeles, CA, 90025, USA.
Jason ShafrinPrecision Health Economics, 11100 Santa Monica Blvd, Suite 500, Los Angeles, CA, 90025, USA.
Darius N LakdawallaSchaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, 90089, USA.
Ainslie HatchOtsuka America Pharmaceutical, Inc., 508 Carnegie Center Drive, Princeton, NJ, 08540, USA.
Felicia M FormaOtsuka Pharmaceutical Development & Commercialization, Inc., 508 Carnegie Center Drive, Princeton, NJ, 08540, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPatients with mental and physical health conditions are complex to treat and often use multiple medications. It is unclear how adherence to one medication predicts adherence to others. A predictive relationship could permit less expensive adherence monitoring if overall adherence could be predicted through tracking a single medication.

methodsTo test this hypothesis, we examined whether patients with multiple mental and physical illnesses have similar adherence trajectories across medications. Specifically, we conducted a retrospective cohort analysis using health insurance claims data for enrollees who were diagnosed with a serious mental illness, initiated an atypical antipsychotic, as well as an SSRI (to treat serious mental illness), biguanides (to treat type 2 diabetes), or an ACE inhibitor (to treat hypertension). Using group-based trajectory modeling, we estimated adherence patterns based on monthly estimates of the proportion of days covered with each medication. We measured the predictive value of the atypical antipsychotic trajectories to adherence predictions based on patient characteristics and assessed their relative strength with the R-squared goodness of fit metric.

resultsWithin our sample of 431,591 patients, four trajectory groups were observed: non-adherent, gradual discontinuation, stop-start, and adherent. The accuracy of atypical antipsychotic adherence for predicting adherence to ACE inhibitors, biguanides, and SSRIs was 44.5, 44.5, and 49.6%, respectively (all p < 0.001 vs. random). We also found that information on patient adherence patterns to atypical antipsychotics was a better predictor of patient adherence to these three medications than would be the case using patient demographic and clinical characteristics alone.

conclusionAmong patients with multiple chronic mental and physical illnesses, patterns of atypical antipsychotic adherence were useful predictors of adherence patterns to a patient's adherence to ACE inhibitors, biguanides, and SSRIs.

fundingOtsuka Pharmaceutical Development & Commercialization, Inc.

Indexed as

Chronic DiseaseDrug MonitoringMental DisordersAdultAntihypertensive AgentsAntipsychotic AgentsComorbidityDatabases, FactualFemaleHumansMaleMedicareMiddle AgedPredictive Value of TestsRetrospective StudiesUnited StatesAntihypertensive AgentsAntipsychotic AgentsAdherenceAtypical anti-psychoticNeurologySerious mental illnessTrajectory model

Identifiers

PMID29725982
PMCPMC5960492

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.