Souza AF, Silva MRD, Santos JBD, Almeida AM, Acurcio FA, Alvares-Teodoro J. Medication adherence and persistence of psoriatic arthritis patients treated with biological therapy in a specialty pharmacy in Brazil: a prospective observational study.
Pharm Pract (Granada) 2021;
19:2312. [PMID:
34221199 PMCID:
PMC8216708 DOI:
10.18549/pharmpract.2021.2.2312]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/02/2021] [Indexed: 01/12/2023] Open
Abstract
Background:
Pharmaceutical services in Brazil provide access, supply, and rational use of
drugs for all population and an effort has been made to improve the quality
of these services. Biological drugs are high-cost drugs supplied in Brazil
that can inhibit disease progression and improve the quality of life of
psoriatic arthritis (PsA) patients. However, some patients did not achieve
therapeutic goals.
Objective:
To evaluate the medication adherence and persistence of PsA patients treated
with tumor necrosis factor inhibitors (anti-TNF) drugs and their associated
factors.
Methods:
A prospective observational study was performed at a single-specialty
pharmacy in Belo Horizonte, Brazil. Medication adherence, persistence, and
clinical outcomes were evaluated at 12 months of follow-up. Medication
persistence was historically compared to overall PsA patients treated in
Brazil. Associated factors were identified through log-binomial
regression.
Results:
One hundred ninety-seven PsA patients were included in the study, of whom 147
(74.6%) and 142 (72.1%) had medication adherence and
persistence, respectively. Patients treated with infliximab presented the
highest adherence (90.5%) and persistence rate (95.2%) in
comparison to patients treated with other drugs, except for adalimumab
versus infliximab for adherence outcome. All clinical measures significantly
improved in patients with medication adherence and persistence. Medication
persistence was higher for patients attended by specialty pharmacy than
other PsA patients in Brazil. The associated factors to higher medication
adherence were lower disease activity by BASDAI, being non-white race, and
intravenous drug use. The associated factors to higher medication
persistence were lower disease activity by Bath Ankylosing Spondylitis
Activity Index (BASDAI), intravenous drug use, non-use of corticoids and
non-steroidal anti-inflammatory drugs, and comorbidity.
Conclusions:
Patients with medication adherence and persistence had significant
improvements in clinical measures, functionality, and quality of life. High
medication adherence and persistence to biological therapy were observed and
associated with lesser disease activity at baseline. Also, medication
persistence to PsA patients attended in specialty pharmacy was higher than
the overall PsA population in Brazil, which indicates the importance of
pharmaceutical services to provide health care and promote the effectiveness
and safety of biological therapies.
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