Electronic monitoring reveals highly variable adherence patterns in patients prescribed ivacaftor (original) (raw)

Journal of Cystic Fibrosis, 2015

Abstract

Previous studies of CF treatments have shown suboptimal adherence, though little has been reported regarding adherence patterns to ivacaftor. Electronic monitoring (EM) of adherence is considered a gold standard of measurement. Adherence rates by EM were prospectively obtained and patterns over time were analyzed. EM-derived adherence rates were compared to pharmacy refill history and self-report. 12 subjects (age 6-48years; CFTR-G551D mutation) previously prescribed ivacaftor were monitored for a mean of 118days. Overall adherence by EM was 61%(SD=28%) and decreased over time. Median duration between doses was 16.9hours (IQR 13.9-24.1hours) and increased over time. There was no correlation between EM-derived adherence and either refill history (84%, r=0.26, p=0.42) or self-report (100%, r=0.40, p=0.22). Despite the promising nature of ivacaftor, our data suggest adherence rates are suboptimal and comparable to other prescribed CF therapies, and more commonly used assessments of adherence may be unreliable.

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