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Adherence with levodopa/carbidopa/entacapone versus levodopa/carbidopa and entacapone as separate tablets in patients with Parkinson's disease.
Curr Med Res Opin. 2010 Jul; 26(7):1543-52.CM

Abstract

BACKGROUND

Observational studies suggest that single-tablet formulations are associated with improved adherence versus the same components taken as separate tablets. The objective of this study was to compare adherence in patients with Parkinson's disease (PD) receiving levodopa therapy as levodopa/carbidopa/entacapone tablets (LCE) versus levodopa/carbidopa (LC) tablets and entacapone (E) as separate tablets (LC and E).

METHODS

This was a retrospective, observational cohort study using a large health insurance claims database. Subjects included persons with a PD diagnosis who were receiving LC without E and then received either an add-on therapy with E as a separate tablet (LC and E) or LCE as one tablet (LCE). The primary study outcome was treatment adherence, estimated from pharmacy refills based on the 'percent of days covered' (PDC) with LCE or LC and E during follow-up and compared for patients receiving LCE and LC and E using multivariate regression analyses.

RESULTS

In multivariate analyses controlling for differences between groups in baseline characteristics, including pre-index dosage of and adherence with LC, receipt of LCE (n = 388) was associated with 79% lower mean non-adherence during follow-up (95% CI: 73-83%; p < 0.001) versus LC and E (n = 823), 86% lower odds of unsatisfactory adherence (95% CI: 80-91%; p < 0.001), and a 26% lower risk of discontinuation (95% CI: 6-42%; p < 0.013).

LIMITATIONS

This was an observational study with the inherent potential for selection bias. Pharmacy claims may not provide an accurate estimate of adherence. Requiring subjects to have a certain number of prescriptions before and after the index date may yield a sample that is not representative of all patients initiating levodopa therapy in typical clinical practice.

CONCLUSIONS

Better adherence with LCE may have important implications for maintaining function in patients receiving chronic oral levodopa therapy. Further research is needed to confirm these results and examine the association between improved adherence and clinical and economic outcomes.

Authors+Show Affiliations

Policy Analysis Inc., Brookline, MA 02245, USA. tdelea@pai2.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20429819

Citation

Delea, Thomas E., et al. "Adherence With Levodopa/carbidopa/entacapone Versus Levodopa/carbidopa and Entacapone as Separate Tablets in Patients With Parkinson's Disease." Current Medical Research and Opinion, vol. 26, no. 7, 2010, pp. 1543-52.
Delea TE, Thomas SK, Hagiwara M, et al. Adherence with levodopa/carbidopa/entacapone versus levodopa/carbidopa and entacapone as separate tablets in patients with Parkinson's disease. Curr Med Res Opin. 2010;26(7):1543-52.
Delea, T. E., Thomas, S. K., Hagiwara, M., & Mancione, L. (2010). Adherence with levodopa/carbidopa/entacapone versus levodopa/carbidopa and entacapone as separate tablets in patients with Parkinson's disease. Current Medical Research and Opinion, 26(7), 1543-52. https://doi.org/10.1185/03007991003780628
Delea TE, et al. Adherence With Levodopa/carbidopa/entacapone Versus Levodopa/carbidopa and Entacapone as Separate Tablets in Patients With Parkinson's Disease. Curr Med Res Opin. 2010;26(7):1543-52. PubMed PMID: 20429819.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adherence with levodopa/carbidopa/entacapone versus levodopa/carbidopa and entacapone as separate tablets in patients with Parkinson's disease. AU - Delea,Thomas E, AU - Thomas,Simu K, AU - Hagiwara,May, AU - Mancione,L, PY - 2010/5/1/entrez PY - 2010/5/1/pubmed PY - 2010/9/30/medline SP - 1543 EP - 52 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 26 IS - 7 N2 - BACKGROUND: Observational studies suggest that single-tablet formulations are associated with improved adherence versus the same components taken as separate tablets. The objective of this study was to compare adherence in patients with Parkinson's disease (PD) receiving levodopa therapy as levodopa/carbidopa/entacapone tablets (LCE) versus levodopa/carbidopa (LC) tablets and entacapone (E) as separate tablets (LC and E). METHODS: This was a retrospective, observational cohort study using a large health insurance claims database. Subjects included persons with a PD diagnosis who were receiving LC without E and then received either an add-on therapy with E as a separate tablet (LC and E) or LCE as one tablet (LCE). The primary study outcome was treatment adherence, estimated from pharmacy refills based on the 'percent of days covered' (PDC) with LCE or LC and E during follow-up and compared for patients receiving LCE and LC and E using multivariate regression analyses. RESULTS: In multivariate analyses controlling for differences between groups in baseline characteristics, including pre-index dosage of and adherence with LC, receipt of LCE (n = 388) was associated with 79% lower mean non-adherence during follow-up (95% CI: 73-83%; p < 0.001) versus LC and E (n = 823), 86% lower odds of unsatisfactory adherence (95% CI: 80-91%; p < 0.001), and a 26% lower risk of discontinuation (95% CI: 6-42%; p < 0.013). LIMITATIONS: This was an observational study with the inherent potential for selection bias. Pharmacy claims may not provide an accurate estimate of adherence. Requiring subjects to have a certain number of prescriptions before and after the index date may yield a sample that is not representative of all patients initiating levodopa therapy in typical clinical practice. CONCLUSIONS: Better adherence with LCE may have important implications for maintaining function in patients receiving chronic oral levodopa therapy. Further research is needed to confirm these results and examine the association between improved adherence and clinical and economic outcomes. SN - 1473-4877 UR - https://www.unboundmedicine.com/medline/citation/20429819/Adherence_with_levodopa/carbidopa/entacapone_versus_levodopa/carbidopa_and_entacapone_as_separate_tablets_in_patients_with_Parkinson's_disease_ L2 - https://www.tandfonline.com/doi/full/10.1185/03007991003780628 DB - PRIME DP - Unbound Medicine ER -