Article Text
Abstract
Background Adherence in patients with hyperparathyroidism (sHPT) secondary to serious kidney disease treated with cinacalcet is very important for their health status.
Purpose To assess the adherence (percentage of days of treatment covered with medicine compared with the total days) observed in patients treated with cinacalcet and to evaluate the effect of the adherence reinforcement measures used with patients when medicine is dispensed in our Pharmacy Service (PS).
Materials and Methods Observational descriptive study (January 2012) of all patients treated with cinacalcet and selection of those with recorded lack of adherence. Tools: medical history, dispensing medicine record. To reinforce adherence the PS produced a brochure with recommendations, supplied pill boxes and designed a patient delay record to report to the medical doctor (MD). The results of adherence reinforcement were recorded in April, 2012.
Results From 66 patients treated with cinacalcet, we selected 13 (19.7%) with a record of at least of 3 delays in collecting the prescription, 6 women and 7 men with a mean age of 65.3. Posology: 120 mg/24 h 7.7% (1), 90 mg/24 h 15.4% (2), 60 mg/24 h 23% (3), 30 mg/24 h 38.5% (5), 30 mg/48 h 7.7% (1) and 30 mg/72 h 7.7% (1). The delay was between 4 and 70 days (15.5 on average). After adherence reinforcement measures, 6 patients collected their medicine punctually when it was next dispensed. After the second intervention, only 1 of the non-adherent patients came on time. All delays were communicated to the MD.
Conclusions Although the doses are simple and the adherence support strategies applied are theoretically adequate, the results aren’t satisfactory. Patients need to be informed of the repercussions of bad adherence and follow-up is needed with a combined strategy between the PS and the MD.
No conflict of interest.