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Electronic monitoring of medication adherence preferred in UC trials
Self-reporting does not accurately reflect adherence to dosing regimens among patients, adherence declines over time and more complex regimens result in lower adherence, a study of two regimens for ulcerative colitis found.
“Ongoing electronic monitoring of medication adherence in clinical research provides a level of information that is not possible with standard methods,” the researchers wrote. “It is likely that self-reported adherence and tablet counts may significantly underestimate adherence.”
The 1-year substudy was done in concurrence with an ulcerative colitis trial comparing a once-daily dosage to a three-times-daily dosage. The analysis examined 56 patients’ adherence to the regimens using self-reporting, tablet counts and a medication event-monitoring system.
It found adherence was generally high (89.3% among self-reporting, 96.7% among tablet counts and 89.2% among those with the monitoring system), but found agreement between the measures was sometimes poor.
Among patients who relapsed, 71.4% properly adhered to their regimen, according to the monitoring system, while 93.4% of those who remained in remission adhered to their regimen, according to the study. The figures did not rise to statistical significance.
The study also found patients on the 3-times-per-day regimen were generally less adherent (OR=0.03; 95% CI, 0.01-0.08) and that adherence was greater on weekdays (OR=1.47; 95% CI, 1.31–1.65) and in the period adjacent to clinical visits (OR=1.43; 95% CI, 1.18–1.72).
“For patients with chronic conditions, required to take long-term medication, simple single-dosing regimens are preferable over more complex ones,” the researchers concluded. “In clinical studies involving patients with long-term chronic conditions, researchers should strongly consider collecting medication adherence data electronically, particularly where patients are given complex dosing regimens to follow.”
Disclosure: See the study for a full list of relevant financial disclosures.