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Adherence to laboratory monitoring among people taking oral drugs for multiple sclerosis: A Canadian population-based study.
Mult Scler. 2020 Mar 06 [Online ahead of print]MS

Abstract

OBJECTIVE

To examine laboratory testing adherence by persons initiating an oral disease-modifying therapy (DMT) for multiple sclerosis (MS).

METHODS

Population-based health administrative and laboratory data were accessed in British Columbia, Canada, to identify everyone filling their first prescription for dimethyl fumarate (DMF), fingolimod or teriflunomide (2011-2015). The proportion of people adherent to each drug monograph's recommended laboratory monitoring schedule, pre- and on-DMT, was estimated. The association between patient characteristics and adherence was examined using multivariable logistic regression.

RESULTS

A total of 1016 people were included (DMF 567, fingolimod 253 and teriflunomide 196). The proportions of people adherent to pre-DMT liver and lymphocyte tests ranged from 88% to 91% and 91% to 94%, respectively, while 77% adhered to pre-DMF urinalysis. Adherence to the first on-DMT liver test was 89% for DMF (within 6 months), 61% for fingolimod (within 3 months) and 40% for teriflunomide (within 1 month). Men were less likely than women to have pre-DMF urinalysis (adjusted odds ratio (aOR); 95% confidence interval (CI): 0.40-0.95) or on-DMF liver (aOR: 0.46; 95% CI: 0.23-0.95) or lymphocyte (aOR: 0.47; 95% CI: 0.22-0.98) tests.

CONCLUSIONS

Adherence to recommended laboratory testing was high (>77%) before oral DMT initiation, but lower once on drug. There is a need to understand the long-term consequences of suboptimal laboratory monitoring and sex differences in the DMT-treated MS population.

Authors+Show Affiliations

Division of Neurology, Department of Medicine, Faculty of Medicine, The Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, UBC Hospital, Vancouver, BC, Canada.Division of Neurology, Department of Medicine, Faculty of Medicine, The Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, UBC Hospital, Vancouver, BC, Canada.Division of Neurology, Department of Medicine, Faculty of Medicine, The Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, UBC Hospital, Vancouver, BC, Canada.Center for Gerontology and Health Care Research, Brown University School of Public Health, Providence, RI, USA.Departments of Internal Medicine and Community Health Science, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.Division of Neurology, Department of Medicine, Faculty of Medicine, The Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, UBC Hospital, Vancouver, BC, Canada.Division of Neurology, Department of Medicine, Faculty of Medicine, The Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, UBC Hospital, Vancouver, BC, Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32141376

Citation

Ng, Huah Shin, et al. "Adherence to Laboratory Monitoring Among People Taking Oral Drugs for Multiple Sclerosis: a Canadian Population-based Study." Multiple Sclerosis (Houndmills, Basingstoke, England), 2020, p. 1352458520910500.
Ng HS, Kingwell E, Zhu F, et al. Adherence to laboratory monitoring among people taking oral drugs for multiple sclerosis: A Canadian population-based study. Mult Scler. 2020.
Ng, H. S., Kingwell, E., Zhu, F., Zhang, T., Marrie, R. A., Carruthers, R., & Tremlett, H. (2020). Adherence to laboratory monitoring among people taking oral drugs for multiple sclerosis: A Canadian population-based study. Multiple Sclerosis (Houndmills, Basingstoke, England), 1352458520910500. https://doi.org/10.1177/1352458520910500
Ng HS, et al. Adherence to Laboratory Monitoring Among People Taking Oral Drugs for Multiple Sclerosis: a Canadian Population-based Study. Mult Scler. 2020 Mar 6;1352458520910500. PubMed PMID: 32141376.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adherence to laboratory monitoring among people taking oral drugs for multiple sclerosis: A Canadian population-based study. AU - Ng,Huah Shin, AU - Kingwell,Elaine, AU - Zhu,Feng, AU - Zhang,Tingting, AU - Marrie,Ruth Ann, AU - Carruthers,Robert, AU - Tremlett,Helen, Y1 - 2020/03/06/ PY - 2020/3/7/entrez KW - Multiple sclerosis KW - cohort studies KW - health administrative data KW - patient safety KW - population-based SP - 1352458520910500 EP - 1352458520910500 JF - Multiple sclerosis (Houndmills, Basingstoke, England) JO - Mult. Scler. N2 - OBJECTIVE: To examine laboratory testing adherence by persons initiating an oral disease-modifying therapy (DMT) for multiple sclerosis (MS). METHODS: Population-based health administrative and laboratory data were accessed in British Columbia, Canada, to identify everyone filling their first prescription for dimethyl fumarate (DMF), fingolimod or teriflunomide (2011-2015). The proportion of people adherent to each drug monograph's recommended laboratory monitoring schedule, pre- and on-DMT, was estimated. The association between patient characteristics and adherence was examined using multivariable logistic regression. RESULTS: A total of 1016 people were included (DMF 567, fingolimod 253 and teriflunomide 196). The proportions of people adherent to pre-DMT liver and lymphocyte tests ranged from 88% to 91% and 91% to 94%, respectively, while 77% adhered to pre-DMF urinalysis. Adherence to the first on-DMT liver test was 89% for DMF (within 6 months), 61% for fingolimod (within 3 months) and 40% for teriflunomide (within 1 month). Men were less likely than women to have pre-DMF urinalysis (adjusted odds ratio (aOR); 95% confidence interval (CI): 0.40-0.95) or on-DMF liver (aOR: 0.46; 95% CI: 0.23-0.95) or lymphocyte (aOR: 0.47; 95% CI: 0.22-0.98) tests. CONCLUSIONS: Adherence to recommended laboratory testing was high (>77%) before oral DMT initiation, but lower once on drug. There is a need to understand the long-term consequences of suboptimal laboratory monitoring and sex differences in the DMT-treated MS population. SN - 1477-0970 UR - https://www.unboundmedicine.com/medline/citation/32141376/Adherence_to_laboratory_monitoring_among_people_taking_oral_drugs_for_multiple_sclerosis:_A_Canadian_population-based_study L2 - https://journals.sagepub.com/doi/10.1177/1352458520910500?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -
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