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Older patients with fibromyalgia more likely to adhere to duloxetine therapy
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Patients with fibromyalgia who were older and had a history of using antidepressants achieved a higher adherence to duloxetine therapy in a recent study.
A cross-sectional, retrospective study analyzed medical and pharmacy records for 4,660 patients with fibromyalgia (FM). The patients (4,130 women) had no prior 90-day use of duloxetine before beginning the therapy between Jan. 1, 2008, and Dec. 31, 2008. The mean age of the patients in the study was 48 years.
Researchers used medication possession ratio (MPR) to measure adherence to duloxetine, with high adherence defined as MPR ≥0.8. They defined persistence as the duration of therapy from the index date to the earliest of: the ending date of the last prescription, date of the first gap of more than 15 days between prescriptions, or the end of the study. Using multiple logistic regression, researchers examined demographic and clinical predictors of adherence. Subgroups were identified as duloxetine-persistent and -adherent patients.
The study found that patients older than 35 years were more likely to adhere to duloxetine therapy compared with patients aged 18 to 35 years, with ORs of 1.42, 1.80 and 2.04 for patients aged 36 to 45 years, 46 to 55, and 56 to 64, respectively (all P<.05). Patients’ prior use of pregabalin (OR=1.23), antidepressants (OR=1.27), selective serotonin reuptake inhibitors (SSRIs) (OR=1.32) or venlafaxine (OR=1.39) was associated with high duloxetine adherence (all P<.05).
In predictors of duloxetine use persistence, researchers again found the strongest association existed in patients older than 35 years vs. patients aged 18 to 35 years (ORs=1.43, 1.85 and 1.89 for the 36-45, 46-55 and 56-64 age groups, respectively; all P<.05). High persistence with duloxetine therapy was associated with prior use of SSRIs (OR=1.28), venlafaxine (OR=1.51), cyclooxygenase-2 selective inhibitors (OR=1.26), anticonvulsants (OR=1.36) or antidepressants (OR=1.27) (all P<.05).
“These findings may be of use in identifying patient subgroups most likely to adhere to and persist with treatment of their FM with duloxetine, thus resulting in reduced health care costs and burden for these patients and their health care providers,” the researchers said.
Disclosure: See the study for a full list of relevant disclosures.
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