TY - JOUR
T1 - Adherence to clotting factors among persons with hemophilia A or B
AU - Armstrong, Edward P.
AU - Malone, Daniel C.
AU - Krishnan, Sangeeta
AU - Wessler, Maj Jacob
PY - 2015
Y1 - 2015
N2 - Objective: Evaluate adherence to clotting factor treatment and associated outcomes for patients with hemophilia using an integrated delivery database. Methods: This was a retrospective, observational study tracking patients between 2006 and 2011. Patients with diagnosis codes for hemophilia were identified. Bleeding and complication rates were annualized over the study period. Medication adherence was assessed using prescription claims for clotting factors by examining sequential time periods of 180 days for each patient’s continuous enrollment. Adherence within the time period was calculated using the ‘days supply’ field divided by 180 days. Under the assumption that severe patients should be treated prophylactically, patients were considered adherent within the time period if the ratio of ‘days supply’ to observed days was 60% or greater. Results: A total of 207 patients (74.9 and 25.1% hemophilia A and B, respectively) met the inclusion/ exclusion criteria. There were 101 (48.8%) mild, 32 (15.5%) moderate, and 74 (35.7%) severe patients with hemophilia. The percentage of time periods where adherence to clotting factors was 60% or greater was 14% (SD = 28%) for mild disease, 21% (SD = 32%) for moderate disease, and 51% (SD = 36%) for severe disease. Among patients with severe disease, 27 (36.5%) were adherent ≤30% of time periods, 22 (29.7%) adherent 31–70% of the time periods, and 25 (33.8%) were adherent ≥71% of time periods. Joint bleeding episodes and hospitalizations were uncommon events among the three groups. Conclusions: Among patients with severe disease, the majority (66.2%) were adherent <70% of the time.
AB - Objective: Evaluate adherence to clotting factor treatment and associated outcomes for patients with hemophilia using an integrated delivery database. Methods: This was a retrospective, observational study tracking patients between 2006 and 2011. Patients with diagnosis codes for hemophilia were identified. Bleeding and complication rates were annualized over the study period. Medication adherence was assessed using prescription claims for clotting factors by examining sequential time periods of 180 days for each patient’s continuous enrollment. Adherence within the time period was calculated using the ‘days supply’ field divided by 180 days. Under the assumption that severe patients should be treated prophylactically, patients were considered adherent within the time period if the ratio of ‘days supply’ to observed days was 60% or greater. Results: A total of 207 patients (74.9 and 25.1% hemophilia A and B, respectively) met the inclusion/ exclusion criteria. There were 101 (48.8%) mild, 32 (15.5%) moderate, and 74 (35.7%) severe patients with hemophilia. The percentage of time periods where adherence to clotting factors was 60% or greater was 14% (SD = 28%) for mild disease, 21% (SD = 32%) for moderate disease, and 51% (SD = 36%) for severe disease. Among patients with severe disease, 27 (36.5%) were adherent ≤30% of time periods, 22 (29.7%) adherent 31–70% of the time periods, and 25 (33.8%) were adherent ≥71% of time periods. Joint bleeding episodes and hospitalizations were uncommon events among the three groups. Conclusions: Among patients with severe disease, the majority (66.2%) were adherent <70% of the time.
KW - Bleeding
KW - Compliance
KW - Hemophilia
KW - Medication adherence
KW - Pharmacy
KW - Regimens
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U2 - 10.1179/1481607845414Y.0000000176
DO - 10.1179/1481607845414Y.0000000176
M3 - Article
C2 - 25001343
SN - 1024-5332
VL - 20
SP - 148
EP - 153
JO - Hematology
JF - Hematology
IS - 3
ER -