Medication Adherence Evaluated Through Electronic Monitors During the 2020 COVID-19 Pandemic Lockdown in Switzerland: A Longitudinal Analysis.

Background

During the 2020 COVID-19 lockdown, patients included in the Interprofessional Medication Adherence Program (IMAP) in Switzerland continued to use electronic monitors (EMs) that registered daily drug-dose intake. We aimed to understand to what extent patients' medication implementation (ie, the extent to which the patient took the prescribed medicine), measured with EMs, was impacted by the lockdown.

Methods

Patients participating in the IMAP were diagnosed with diabetic kidney disease (DKD), solid cancer, human immunodeficiency virus (HIV) and miscellaneous long-term diseases (MLTD). Patient implementation was defined through a proxy: if all patient EMs were opened at least once daily, implementation was considered active (=1), and no implementation was considered (=0) otherwise. Implementation before (from December 2019 to March 2020), during (March to June 2020) and after (June to September 2020) the lockdown was compared. Subanalyses were performed according to the patients' diseases. Subanalyses were performed in patients who used at least one EM in 2018-2019 during the same periods (defined as winter, spring and summer). The logistic regression models used to estimate medication implementation according to the period were fitted using generalized estimating equations.

Results

In 2020, patient implementation (n = 118) did not differ significantly before versus during (OR = 0.98, 95% CI: 0.84-1.15, p = 0.789) and before versus after (OR = 0.91, 95% CI: 0.79-1.06, p = 0.217) the lockdown. These findings remained stable when separately analyzing the implementation of patients with HIV (n = 61), DKD (n = 25) or MLTD (n = 22). Too few patients with cancer were included (n = 10) to interpret the results. In 2019, the implementation of 61/118 (51.7%) patients was significantly lower during summertime versus wintertime (OR = 0.73, 95% CI: 0.60-0.89, p = 0.002).

Conclusion

Medication implementation remained steady before, during and after the lockdown in 2020. The IMAP before, during and after the lockdown may have supported the adherence of most patients, by ensuring continuity of care during periods of routine disturbances.

Informations de copyright

© 2022 Bandiera et al.

Déclaration de conflit d'intérêts

Prof. Dr. Grégoire Wuerzner reports consultancy and/or advisory board from Aktiia, Bayer, Servier and AstraZeneca, outside the submitted work. Prof. Dr. Gilles Wandeler reports grants, Speaker and advisory board fees paid to their institution from Gilead Sciences and MSD, grants from Roche Diagnostics, advisory board fees paid to their institution from ViiV, outside the submitted work. Dr Anna Dorothea Wagner reports personal fees, non-financial support from Merck, personal fees from Lily, personal fees from Pierre-Fabre Pharma, is coordinating investigator of EORTC trial 1203 “INNOVATION”, which is supported by an educational grant to EORTC from Hoffmann La Roche, personal fees from Sanofi, personal fees from Daiichi Sankyo, personal fees from Dragonfly Therapeutics, personal fees from Servier, personal fees from Bristol-Myers Squibb, personal fees from Astellas Pharma, outside the submitted work. Professor Chantal Csajka reports grants from Swiss Cancer Research, during the conduct of the study. Prof. Dr. Matthias Cavassini reports grants from Gilead, ViiV and MSD, outside the submitted work. Professor Marie Schneider reports grants from Swiss Cancer Research Foundation, grants from Research and quality fund of Santésuisse, Curafutura and PharmaSuisse, during the conduct of the study. The authors declare that they have no other competing interests.