Achieving optimal adherence to medical therapy by telehealth: Findings from the ORBITA medication adherence sub-study.
Aged
Angina, Stable
/ surgery
Calcium Channel Blockers
/ therapeutic use
Cardiovascular Agents
/ therapeutic use
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
/ therapeutic use
Male
Medication Adherence
/ statistics & numerical data
Middle Aged
Percutaneous Coronary Intervention
Platelet Aggregation Inhibitors
/ therapeutic use
Self Report
Single-Blind Method
Telemedicine
United Kingdom
cardiovascular diseases
chromatography, liquid
coronary artery disease
medication adherence
therapeutics
Journal
Pharmacology research & perspectives
ISSN: 2052-1707
Titre abrégé: Pharmacol Res Perspect
Pays: United States
ID NLM: 101626369
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
06
10
2020
revised:
25
11
2020
accepted:
07
12
2020
entrez:
11
2
2021
pubmed:
12
2
2021
medline:
12
11
2021
Statut:
ppublish
Résumé
The ORBITA trial of percutaneous coronary intervention (PCI) versus a placebo procedure for patients with stable angina was conducted across six sites in the United Kingdom via home monitoring and telephone consultations. Patients underwent detailed assessment of medication adherence which allowed us to measure the efficacy of the implementation of the optimization protocol and interpretation of the main trial endpoints. Prescribing data were collected throughout the trial. Self-reported adherence was assessed, and urine samples collected at pre-randomization and at follow-up for direct assessment of adherence using high-performance liquid chromatography with tandem mass spectrometry (HPLC MS/MS). Self-reported adherence was >96% for all drugs in both treatment groups at both stages. The percentage of samples in which drug was detected at pre-randomization and at follow-up in the PCI versus placebo groups respectively was: clopidogrel, 96% versus 90% and 98% versus 94%; atorvastatin, 95% versus 92% and 92% versus 91%; perindopril, 95% versus 97% and 85% versus 100%; bisoprolol, 98% versus 99% and 96% versus 97%; amlodipine, 99% versus 99% and 94% versus 96%; nicorandil, 98% versus 96% and 94% versus 92%; ivabradine, 100% versus 100% and 100% versus 100%; and ranolazine, 100% versus 100% and 100% versus 100%. Adherence levels were high throughout the study when quantified by self-reporting methods and similarly high proportions of drug were detected by urinary assay. The results indicate successful implementation of the optimization protocol delivered by telephone, an approach that could serve as a model for treatment of chronic conditions, particularly as consultations are increasingly conducted online.
Identifiants
pubmed: 33570248
doi: 10.1002/prp2.710
pmc: PMC7876856
doi:
Substances chimiques
Calcium Channel Blockers
0
Cardiovascular Agents
0
Hydroxymethylglutaryl-CoA Reductase Inhibitors
0
Platelet Aggregation Inhibitors
0
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e00710Subventions
Organisme : British Heart Foundation
ID : FS/17/16/32560
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/V001620/1
Pays : United Kingdom
Organisme : Department of Health
Pays : United Kingdom
Investigateurs
Sayan Sen
(S)
Ricardo Petraco
(R)
Christopher Cook
(C)
Yousif Ahmad
(Y)
James Howard
(J)
Matthew Shun-Shin
(M)
Jamil Mayet
(J)
Jaspal Kooner
(J)
Ramzi Khamis
(R)
Kare Tang
(K)
John Davies
(J)
Thomas Keeble
(T)
Raffi Kaprielian
(R)
Iqbal Malik
(I)
Sukhjinder Nijjer
(S)
Amarjit Sethi
(A)
Christopher Baker
(C)
Punit Ramrakha
(P)
Ravi Assomull
(R)
Rodney Foale
(R)
Nearchos Hadjiloizou
(N)
Masood Khan
(M)
Michael Bellamy
(M)
Ghada Mikhail
(G)
Piers Clifford
(P)
Andrew Sharp
(A)
Robert Gerber
(R)
Suneel Talwar
(S)
Peter O'Kane
(P)
Terry Levy
(T)
Rosie Swallow
(R)
Roland Wensel
(R)
Informations de copyright
© 2021 The Authors. Pharmacology Research & Perspectives published by John Wiley & Sons Ltd, British Pharmacological Society and American Society for Pharmacology and Experimental Therapeutics.
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