Longitudinal Study of Therapeutic Adherence in a Cystic Fibrosis Unit: Identifying Potential Factors Associated with Medication Possession Ratio
Abstract
:1. Introduction
2. Results
2.1. Demographic and Clinical Characteristics
2.2. The Relationship between Compliance and Lung Function
2.3. Analysis of Variables with Higher Relevance in the Percentage of MPR
3. Discussion
4. Materials and Methods
4.1. Patient Recruitment
4.2. AT Assessment and Collection of Clinical Variables
4.3. Statistical Analysis
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Demographic and Clinical Characteristics | Total (n = 57) | MPR < 50 (n = 8) | MPR 50–80 (n = 19) | MPR > 80 (n = 30) | p-Value |
---|---|---|---|---|---|
Age, (mean ± SD) | 33.9 ± 9.4 | 28.5 ± 6.3 | 32.0 ± 10.5 | 36.5 ± 8.7 | 0.030 *4 |
20–30 yrs., n (%) | 25 (43.9%) | 6 (75.0%) | 11 (57.9%) | 8 (26.7%) | 0.017 * |
30–40 yrs., n (%) | 16 (28.1%) | 1 (12.5%) | 4 (21.1%) | 11 (36.7%) | 0.421 |
≥40 yrs., n (%) | 16 (28.1%) | 1 (12.5%) | 4 (21.1%) | 11 (36.7%) | 0.421 |
Gender, n (%) | |||||
Women | 34 (59.6%) | 4 (50.0%) | 11 (57.9%) | 19 (63.3%) | 0.810 |
BMI, (mean ± SD) | 23.2 ± 3.4 | 22.1 ± 1.7 | 23.7 ± 4.5 | 23.2 ± 2.9 | 0.786 |
Genotype, n (%) | |||||
F508del/F508del | 20 (35.1%) | 1 (12.5%) | 5 (26.3%) | 14 (46.7%) | 0.145 |
F508del/other | 23 (40.4%) | 4 (50.0%) | 11 (57.9%) | 8 (26.7%) | 0.072 |
other/other | 14 (24.6%) | 3 (37.5%) | 3 (15.8%) | 8 (26.7%) | 0.429 |
Pancreatic insufficient, n (%) | 46 (80.7%) | 6 (75.0%) | 15 (78.9%) | 25 (83.3%) | 0.727 |
Diabetes, n (%) | 24 (42.1%) | 4 (50.0%) | 8 (42.1%) | 12 (40.0%) | 0.933 |
Allergic bronchopulmonary aspergillosis, n (%) | 14 (24.6%) | 2 (25.0%) | 3 (15.8%) | 9 (30.0%) | 0.529 |
Massive hemoptysis, n (%) | 9 (15.8%) | 1 (12.5%) | 2 (10.5%) | 6 (20.0%) | 0.783 |
Lung function, (mean ± SD) | |||||
FEV1 1 % | |||||
2019 | 71.0 ± 20.3 | 80.5 (16.8) | 75.4 (23.7) | 65.7 (17.8) | 0.099 |
2020 | 72.9 ± 18.5 | 84.1 (15.7) | 76.4 (22.2) | 67.6 (15.1) | 0.042 |
2021 3 | 71.8 ± 18.7 | 82.0 (10.2) | 76.4 (22.5) | 66.9 (16.1) | 0.059 |
Total | 72.2 ± 18.9 | 81.7 (15.1) | 76.4 (22.5) | 66.9 (16.1) | 0.069 |
FVC% 2 | |||||
2019 | 82.7 ± 15.6 | 90.0 (13.0) | 86.1 (14.7) | 78.5 (15.9) | 0.094 |
2020 | 88.1 ± 14.0 | 99.3 (11.6) | 90.6 (14.1) | 83.5 (12.7) | 0.009 * |
2021 1 | 87.9 ± 13.6 | 96.3 (12.9) | 91.1 (13.8) | 84.2 (12.7) | 0.059 |
Total | 86.5 ± 13.9 | 95.0 (11.6) | 89.6 (13.8) | 82.2 (13.3) | 0.031 |
Bacteria presence, n (%) | |||||
Chronic bronchial infection | 48 (84.2%) | 8 (100%) | 16 (84.2%) | 24 (80.0%) | 0.593 |
Pseudomonas aeruginosa | 22 (38.6%) | 1 (12.5%) | 6 (31.6%) | 15 (50.0%) | 0.377 |
methicillin-sensitive Staphylococcus aureus (MSSA) | 16 (28.1%) | 4 (50.0%) | 7 (36.8%) | 5 (16.7%) | 0.511 |
methicillin-resistant Staphylococcus aureus (MRSA) | 10 (17.5%) | 2 (25.0%) | 3 (15.8%) | 5 (16.7%) | 0.951 |
Achromobacter xylosoxidans | 6 (10.5%) | 1 (12.5%) | 3 (15.8%) | 2 (6.7%) | 0.921 |
Burkholderia cepacia | 5 (8.8%) | 1 (12.5%) | 1 (5.26%) | 3 (10.0%) | 0.915 |
Aspergillus sp | 1 (1.8%) | 0 (0.0%) | 0 (0.0%) | 1 (3.3%) | 0.806 |
Haemophilus influenzae | 6 (10.5%) | 4 (50.0%) | 0 (0.0%) | 2 (6.7%) | 0.004 * |
Stenotrophomonas maltophilia | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 1.000 |
Mycobacteria non tuberculous | 1 (1.8%) | 0 (0.0%) | 0 (0.0%) | 1 (3.33%) | 0.806 |
Year | Oral Administration | Intravenous Administration | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Total (n = 57) | MPR < 50 (n = 8) | MPR 50–80 (n = 19) | MPR > 80 (n = 30) | p-Value | Total (n = 57) | MPR < 50 (n = 8) | MPR 50–80 (n = 19) | MPR > 80 (n = 30) | p-Value | ||
Exacerbations (mean ± SD) | 2019 | 2.1 ± 1.9 | 1.6 ± 1.2 | 2.2 ± 1.7 | 2.1 ± 2.1 | 0.763 | 0.4 ± 0.8 | 0.0 ± 0.0 | 0.4 ± 0.9 | 0.5 ± 0.9 | 0.220 |
2020 | 1.8 ± 1.6 | 1.5 ± 0.9 | 1.4 ± 1.6 | 2.1 ± 1.7 | 0.228 | 0.2 ± 0.4 | 0.0 ± 0.0 | 0.3 ± 0.5 | 0.3 ± 0.5 | 0.217 | |
2021 | 0.9 ± 1.0 | 0.9 ± 1.2 | 0.9 ± 0.9 | 0.8 ± 1.0 | 0.858 | 0.0 ± 0.1 | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.0 ± 0.2 | 0.648 | |
Total | 1.5 ± 1.1 | 1.4 ± 0.7 | 1.5 ± 1.1 | 1.7 ± 1.3 | 0.71 | 0.2 ± 0.3 | 0.0 ± 0.0 | 0.2 ± 0.3 | 0.3 0.4 | 0.072 | |
≥1 exacerbation, n (%) | 2019 | 43 (75.4%) | 6 (75.0%) | 15 (78.9%) | 22 (73.3%) | 0.905 | 14 (24.6%) | 0 (0.0%) | 5 (26.3%) | 9 (30.0%) | 0.211 |
2020 | 43 (75.4%) | 7 (87.5%) | 12 (63.2%) | 24 (80.0%) | 0.285 | 14 (24.6%) | 0 (0.0%) | 5 (26.3%) | 9 (30.0%) | 0.211 | |
2021 | 31 (54.4%) | 3 (37.5%) | 12 (63.2%) | 16 (53.3%) | 0.467 | 1 (1.8%) | 0 (0.0%) | 0 (0.0%) | 1 (3.3%) | 0.633 | |
Total | 42 (73.7%) | 7 (87.5%) | 14 (73.7%) | 21 (70.0%) | 0.607 | 4 (7.0%) | 0 (0.0%) | 1 (5.3%) | 3 (10.0%) | 0.576 | |
Days 2 (mean ± SD) | 2019 | 47.9 ± 32.5 | 33.7 (10.1) | 48.5 (24.4) | 51.1 (39.9) | 0.548 | 26.6 ± 14.01 | NA 3 ± NA | 26.6 ± 17.4 | 26.6±12.9 | 0.838 |
2020 | 42.2 ± 31.0 | 30.0 (18.4) | 37.9 (23.8) | 47.9 (36.2) | 0.452 | 16.2 ± 4.7 | NA ± NA | 18.2 ± 3.8 | 15.1±5.0 | 0.246 | |
2021 | 29.5 ± 18.6 | 35.0 (18.5) | 21.6 (11.3) | 34.3 (21.8) | 0.137 | 14.0 ± ND | NA ± NA | NA ± NA | 14.0 ± NA | NA | |
Total | 30.8 ± 22.4 | 22.9 (12.4) | 28.9 (16.1) | 34.2 (27.1) | 0.568 | 9.7 ± 5.5 | NA ± NA | 10.7 ± 4.2 | 9.3 ± 6.2 | 0.275 |
Variable | MPR > 80 | MPR < 50 | ||
---|---|---|---|---|
MDA | MDG | MDA | MDG | |
Gender | −1.1 | 0.5 | 0.3 | 0.3 |
Age | 0.5 | 3.0 | −0.1 | 1.3 |
Genotype | 2.8 | 1.9 | −2.1 | 0.4 |
Pancreatic insufficient | 0.0 | 0.1 | −0.1 | 0.1 |
Diabetes | 1.6 | 0.5 | −1.6 | 0.2 |
Allergic bronchopulmonary aspergillosis | 0.1 | 0.5 | 0.4 | 0.2 |
Massive haemoptysis | −1.1 | 0.6 | −2.1 | 0.1 |
BMI | 0.3 | 1.8 | −0.9 | 1.4 |
Chronic bronchial infection | 0.1 | 0.3 | 1.9 | 0.1 |
Pseudomonas aeruginosa | 0.0 | 0.1 | −0.1 | 0.1 |
methicillin-sensitive Staphylococcus aureus (MSSA) | 1.1 | 2.5 | 0.2 | 0.3 |
methicillin-resistant Staphylococcus aureus (MRSA) | 0.0 | 0.0 | 0.0 | 0.3 |
Achromobacter xylosoxidans | 0.0 | 0.3 | −0.2 | 0.2 |
Burkholderia cepacia | 0.0 | 0.0 | −0.1 | 0.1 |
Aspergillus sp | 0.0 | 0.0 | 0.0 | 0.0 |
Haemophilus influenzae | 0.0 | 0.0 | 5.7 | 1.4 |
Mycobacteria non tuberculous | 0.0 | 0.3 | 0.0 | 0.1 |
Total exacerbations by intravenous administration | 0.0 | 0.1 | 0.0 | 0.0 |
Total exacerbations by oral administration | −1.1 | 0.7 | 0.1 | 0.1 |
Hypertonic saline solution | 1.1 | 0.2 | 3.7 | 1.0 |
DNAsa | −0.9 | 0.3 | 3.3 | 0.5 |
Azithromycin | 0.0 | 0.4 | 1.7 | 0.3 |
Aztreonam solution for inhalation | 1.1 | 0.4 | 0.1 | 0.1 |
Tobramycin in solution for inhalation | 1.5 | 0.3 | −0.8 | 0.0 |
Colistin dry powder | −1.6 | 0.6 | 0.6 | 0.1 |
Colistin in solution for inhalation by INEB | 0.0 | 0.0 | 0.8 | 0.1 |
Ivacaftor | 0.0 | 0.0 | 0.0 | 0.1 |
Ivacaftor/Tezacaftor | −0.2 | 3.0 | 1.7 | 0.1 |
Elexacaftor, Tezacaftor/Ivacaftor | 0.0 | 0.0 | 1.0 | 0.0 |
Vitamins | 0.0 | 0.0 | 0.9 | 0.2 |
Intravenous formulation | 0.0 | 0.1 | −0.8 | 0.1 |
Total FVC% | 1.6 | 2.1 | 2.3 | 1.4 |
TotalFEV1% | 1.6 | 3.3 | 2.0 | 1.4 |
Total days of intravenous exacerbations | 0.8 | 1.0 | 0.2 | 0.3 |
Total days of oral exacerbations | 0.9 | 3.0 | 0.6 | 0.9 |
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Girón, R.M.; Peláez, A.; Ibáñez, A.; Martínez-Besteiro, E.; Gómez-Punter, R.M.; Martínez-Vergara, A.; Ancochea, J.; Morell, A. Longitudinal Study of Therapeutic Adherence in a Cystic Fibrosis Unit: Identifying Potential Factors Associated with Medication Possession Ratio. Antibiotics 2022, 11, 1637. https://doi.org/10.3390/antibiotics11111637
Girón RM, Peláez A, Ibáñez A, Martínez-Besteiro E, Gómez-Punter RM, Martínez-Vergara A, Ancochea J, Morell A. Longitudinal Study of Therapeutic Adherence in a Cystic Fibrosis Unit: Identifying Potential Factors Associated with Medication Possession Ratio. Antibiotics. 2022; 11(11):1637. https://doi.org/10.3390/antibiotics11111637
Chicago/Turabian StyleGirón, Rosa Mª, Adrián Peláez, Amparo Ibáñez, Elisa Martínez-Besteiro, Rosa Mar Gómez-Punter, Adrián Martínez-Vergara, Julio Ancochea, and Alberto Morell. 2022. "Longitudinal Study of Therapeutic Adherence in a Cystic Fibrosis Unit: Identifying Potential Factors Associated with Medication Possession Ratio" Antibiotics 11, no. 11: 1637. https://doi.org/10.3390/antibiotics11111637