20.500.12556/DKUM-79334 Adherenca in persistenca pri imunomodulatornih zdravilih za multiplo sklerozo izdanih na recept Assessment of adherence and persistence to immunomodulatory treatment for multiple sclerosis, based on pharmacy prescriptions Uvod: V zadnjih letih je bilo zaslediti povečan trend opravljenih študij na osnovi izdanih receptov, kar nam je omogočilo zajeti velik raziskovalni vzorec uporabnikov imunomodulatornih zdravil (IMZ) pri multipli sklerozi med letoma 2011 in 2015. Na osnovi teh smo izračunali adherenco in persistenco IMZ uporabnikov na zdravila. Metode: Adherenca je bila ocenjena na osnovi metode CMA5 v persistentnem obdobju z dovoljenimi vrzelmi do 180 dni. Vpliv neodvisnih spremenljivk na adherenco in persistenco je modeliran z multivariatno logistično regresijo in Coxovo regresijo. Rezultati: Mediana CMA5 in delež adherentnih terapevtskih epizod je pri enem letu uporabe in več kot enem letu uporabe IMZ pri peroralnih IMZ (teriflunomid (TERI) in dimetilfumarat (DMF)) enaka (0,994, 86,8 %) in (0,994 in 85,9 %), pri fingolimodu (0,96, 81,7 %) in (0,983, 88 %), ter pri injekcijskih IMZ (0,966, 59,9 %) in (0,968, 75,4 %). Stopnja persistence terapevtskih epizod med 2011 in 2013 je po šestih mesecih in enem letu enaka (prekinitve, zamenjave), (95,3 %, 88,8 % in 98,4 %, 96,8 %) za fingolimod ter (91,4 %, 86,7 % in 97,1 %, 95,2 %) za injekcijska IMZ. Med letoma 2014 in 2015 je persistenca enaka (94,5 %, 93,2 % in 97,7 % in 95,4 %) za fingolimod, (91 %, 89 % in 92,4 %, 89,6 %) za injekcijska IMZ ter (95,5 %, 95,4 % in 97,7 % in 96,6 %) za TERI in DMF skupaj. Terapija z drugim zdravilom, izkušena kohorta in druga peroralna IMZ pozitivno vplivajo na adherenco (OR = 2,899, IZ (1,659−5,357)), (OR = 0,301, IZ (0,223−0,405), (OR = 3,478, IZ (1,959−6,174)). Razprava in sklep: Prejemniki peroralnih IMZ (TERI in DMF) in fingolimoda so bolj adherentni in persistentni na predpisano terapijo kot prejemniki injekcijskih IMZ. Introduction: We have seen an increased trend of studies performed based on issued prescriptions, which enabled us to capture a larger research sample of disease modifying therapy (DMT) users in multiple sclerosis between the years 2011-2015. Based on prescription claims, we calculated the adherence to DMT and drug persistence. Methods: Adherence was assessed based on CMA5 in a persistent period, with allowed gaps of up to 180 days. The influence of independent variables on adherence and persistence is modeled by multivariate logistic regression and Cox regression. Results: The median CMA5 and the proportion of adherent therapeutic episodes up to 1 year and more than 1 year of persistent use is (0.994, 86.8%) and (0.994 and 85.9%) for oral DMT (TERI and DMF), (0, 96, 81.7%) and (0.983, 88%) for fingolimod, and (0.966, 59.9%) and (0.968, 75.4%) for injectable IMZ. The persistence rate of therapeutic episodes initiated between 2011-2013, after 6 months and 1 year (discontinuation, switch) is (95.3%, 88.8% and 98.4%, 96.8%) for fingolimod, (91.4%, 86.7% and 97.1%, 95.2%) for injectable DMT. For therapeutic episodes initiated between 2014-2015, the persistence rate was (94.5%, 93.2% and 97.7% and 95.4%) for fingolimod, (91%, 89% and 92.4%, 89.6%) for injection DMF and (95.5%, 95.4% and 97.7% and 96.6%) for TERI and DMF joined. Switch to 2nd drug, experienced cohort and other oral DMF (TERI and DMF) have an effect on adherence (OR = 2,899, IZ (1,659-5,357)), (OR = 0,301, IZ (0,223-0,405), (OR = 3,478, IZ 1,959- 6,174)). Discussion and conclusion: Recipients of oral DMT (TERI and DMF) and fingolimod are more adherent and persistent to prescribed therapy than recipients of injectable DMF. multipla skleroza Kaplan–Meier krivulja imunomodulatorna zdravila populacijska študija retrospektivna analiza. Multiple Sclerosis Kaplan – Meier curve imunommodulatory drugs population study retrospective analysis. true false false [I. Radić] Slovenski jezik Angleški jezik Magistrsko delo/naloga 2021-06-14 13:20:56 2021-08-17 15:00:05 2022-08-09 20:26:26 0000-00-00 00:00:00 2021 0 Maribor 0 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.382-004:615.375(043.2) 73104643 MAG_Radic_Ivana_2021.pdf MAG_Radic_Ivana_2021.pdf 1 9C8A836FF57B2DEEBE4598539A6B4797 8750b0254ff5f2afb2c1b2e8a6411fb15bda7580f9b65ca9d567b6ba3a007c5b a1a5ca0d-ed57-11eb-a331-00155d581298 20.500.12556/dkum/c71a65f2-8c1b-45e0-a24e-f4f764ab753f https://dk.um.si/Dokument.php?lang=slv&id=151407 Fakulteta za zdravstvene vede 0 0 0