Lieke Roeke, Liesbeth I van de Ven, Steffie E M Vonk, Jan J M Coremans, Edward Dompeling, Michiel A G E Bannier, Fatma Karapinar-Çarkit, Judith de Ruijter-van Dalem
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引用次数: 0
Abstract
Background: People with cystic fibrosis (pwCF) have complex treatment regimens with cystic fibrosis transmembrane conductance regulator (CFTR) modulators and supportive therapies. Evidence on adherence across cystic fibrosis (CF) therapies using different assessment methods and the added value of medication reviews remains limited.
Objective(s): This study compared adherence across CF therapies using three assessment methods and evaluated the contribution of medication reviews.
Methods: This cross-sectional study (February to April 2025) included pediatric and adult pwCF at Maastricht University Medical Centre+. Adherence to CFTR modulators and supportive therapies (vitamin supplements, pancreatic enzymes, inhalers, and nebulizers) was assessed with pharmacy refill data (medication possession ratio, MPR); self-reported adherence (Medication Adherence Report Scale-5, MARS-5), and structured medication reviews. The primary outcome was the proportion of pwCF adherent to CF medication per assessment method. Secondary outcomes were the within-patient differences in adherence between CFTR and supportive therapies (McNemar's exact test) based on MPR and the number and acceptance of DRP-interventions in the medication review.
Results: Forty-three pwCF (17 children, 26 adults; 39.5% female) were included. For CFTR modulators, adherence was 91.7% (MPR), 91.2% (MARS-5), and 72.2% (medication review). For supportive therapies, adherence was 56.3%, 77.7%, and 77.4%, respectively. Four nonadherent pwCF were identified exclusively through medication review. Within-patients, adherence was higher for CFTR modulators than for supportive therapies (p < 0.001). Medication reviews identified 51 DRPs in 41 pwCF (including nonadherence in 12 pwCF), all proposed interventions were accepted by the treating physician.
Conclusion: Adherence varied by medication class and assessment method. Medication reviews provided clinically relevant information in addition to refill-based and self-reported measures.
期刊介绍：
Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases.
PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.
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