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Adherence with levodopa/carbidopa/entacapone versus levodopa/carbidopa and entacapone as separate tablets in patients with Parkinson's disease
Observational studies suggest that single-tablet formulations are associated with improved adherence versus the same components taken as separate tablets. The objective of this study was to compare adherence in patients with Parkinson's disease (PD) receiving levodopa therapy as levodopa/carbid...
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| Published in: | Current medical research and opinion 2010-07, Vol.26 (7), p.1543-1552 |
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| container_title | Current medical research and opinion |
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| creator | Delea, Thomas E. Thomas, Simu K. Hagiwara, May Mancione, L. |
| description | Observational studies suggest that single-tablet formulations are associated with improved adherence versus the same components taken as separate tablets. The objective of this study was to compare adherence in patients with Parkinson's disease (PD) receiving levodopa therapy as levodopa/carbidopa/entacapone tablets (LCE) versus levodopa/carbidopa (LC) tablets and entacapone (E) as separate tablets (LC and E).
This was a retrospective, observational cohort study using a large health insurance claims database. Subjects included persons with a PD diagnosis who were receiving LC without E and then received either an add-on therapy with E as a separate tablet (LC and E) or LCE as one tablet (LCE). The primary study outcome was treatment adherence, estimated from pharmacy refills based on the 'percent of days covered' (PDC) with LCE or LC and E during follow-up and compared for patients receiving LCE and LC and E using multivariate regression analyses.
In multivariate analyses controlling for differences between groups in baseline characteristics, including pre-index dosage of and adherence with LC, receipt of LCE (n = 388) was associated with 79% lower mean non-adherence during follow-up (95% CI: 73-83%; p |
| doi_str_mv | 10.1185/03007991003780628 |
| format | article |
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This was a retrospective, observational cohort study using a large health insurance claims database. Subjects included persons with a PD diagnosis who were receiving LC without E and then received either an add-on therapy with E as a separate tablet (LC and E) or LCE as one tablet (LCE). The primary study outcome was treatment adherence, estimated from pharmacy refills based on the 'percent of days covered' (PDC) with LCE or LC and E during follow-up and compared for patients receiving LCE and LC and E using multivariate regression analyses.
In multivariate analyses controlling for differences between groups in baseline characteristics, including pre-index dosage of and adherence with LC, receipt of LCE (n = 388) was associated with 79% lower mean non-adherence during follow-up (95% CI: 73-83%; p < 0.001) versus LC and E (n = 823), 86% lower odds of unsatisfactory adherence (95% CI: 80-91%; p < 0.001), and a 26% lower risk of discontinuation (95% CI: 6-42%; p < 0.013).
This was an observational study with the inherent potential for selection bias. Pharmacy claims may not provide an accurate estimate of adherence. Requiring subjects to have a certain number of prescriptions before and after the index date may yield a sample that is not representative of all patients initiating levodopa therapy in typical clinical practice.
Better adherence with LCE may have important implications for maintaining function in patients receiving chronic oral levodopa therapy. Further research is needed to confirm these results and examine the association between improved adherence and clinical and economic outcomes.</description><identifier>ISSN: 0300-7995</identifier><identifier>EISSN: 1473-4877</identifier><identifier>DOI: 10.1185/03007991003780628</identifier><identifier>PMID: 20429819</identifier><language>eng</language><publisher>England: Taylor & Francis</publisher><subject><![CDATA[Adherence ; Aged ; Aged, 80 and over ; Algorithms ; Antiparkinson Agents - administration & dosage ; Antiparkinson Agents - adverse effects ; Carbidopa - administration & dosage ; Carbidopa - adverse effects ; Catechols - administration & dosage ; Catechols - adverse effects ; Cohort Studies ; Dosage Forms ; Drug Combinations ; Female ; Humans ; Levodopa - administration & dosage ; Levodopa - adverse effects ; Male ; Middle Aged ; Motor complications ; Nitriles - administration & dosage ; Nitriles - adverse effects ; Parkinson Disease - drug therapy ; Parkinson Disease - epidemiology ; Parkinson's disease ; Patient Compliance - statistics & numerical data ; Retrospective Studies ; Tablets ; Wearing-off]]></subject><ispartof>Current medical research and opinion, 2010-07, Vol.26 (7), p.1543-1552</ispartof><rights>2010 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-3af51aacbe4ed93036ceb80939f34b3ffd99878cef5d191d349d9fbfb324c8813</citedby><cites>FETCH-LOGICAL-c353t-3af51aacbe4ed93036ceb80939f34b3ffd99878cef5d191d349d9fbfb324c8813</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20429819$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Delea, Thomas E.</creatorcontrib><creatorcontrib>Thomas, Simu K.</creatorcontrib><creatorcontrib>Hagiwara, May</creatorcontrib><creatorcontrib>Mancione, L.</creatorcontrib><title>Adherence with levodopa/carbidopa/entacapone versus levodopa/carbidopa and entacapone as separate tablets in patients with Parkinson's disease</title><title>Current medical research and opinion</title><addtitle>Curr Med Res Opin</addtitle><description>Observational studies suggest that single-tablet formulations are associated with improved adherence versus the same components taken as separate tablets. The objective of this study was to compare adherence in patients with Parkinson's disease (PD) receiving levodopa therapy as levodopa/carbidopa/entacapone tablets (LCE) versus levodopa/carbidopa (LC) tablets and entacapone (E) as separate tablets (LC and E).
This was a retrospective, observational cohort study using a large health insurance claims database. Subjects included persons with a PD diagnosis who were receiving LC without E and then received either an add-on therapy with E as a separate tablet (LC and E) or LCE as one tablet (LCE). The primary study outcome was treatment adherence, estimated from pharmacy refills based on the 'percent of days covered' (PDC) with LCE or LC and E during follow-up and compared for patients receiving LCE and LC and E using multivariate regression analyses.
In multivariate analyses controlling for differences between groups in baseline characteristics, including pre-index dosage of and adherence with LC, receipt of LCE (n = 388) was associated with 79% lower mean non-adherence during follow-up (95% CI: 73-83%; p < 0.001) versus LC and E (n = 823), 86% lower odds of unsatisfactory adherence (95% CI: 80-91%; p < 0.001), and a 26% lower risk of discontinuation (95% CI: 6-42%; p < 0.013).
This was an observational study with the inherent potential for selection bias. Pharmacy claims may not provide an accurate estimate of adherence. Requiring subjects to have a certain number of prescriptions before and after the index date may yield a sample that is not representative of all patients initiating levodopa therapy in typical clinical practice.
Better adherence with LCE may have important implications for maintaining function in patients receiving chronic oral levodopa therapy. Further research is needed to confirm these results and examine the association between improved adherence and clinical and economic outcomes.</description><subject>Adherence</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Algorithms</subject><subject>Antiparkinson Agents - administration & dosage</subject><subject>Antiparkinson Agents - adverse effects</subject><subject>Carbidopa - administration & dosage</subject><subject>Carbidopa - adverse effects</subject><subject>Catechols - administration & dosage</subject><subject>Catechols - adverse effects</subject><subject>Cohort Studies</subject><subject>Dosage Forms</subject><subject>Drug Combinations</subject><subject>Female</subject><subject>Humans</subject><subject>Levodopa - administration & dosage</subject><subject>Levodopa - adverse effects</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Motor complications</subject><subject>Nitriles - administration & dosage</subject><subject>Nitriles - adverse effects</subject><subject>Parkinson Disease - drug therapy</subject><subject>Parkinson Disease - epidemiology</subject><subject>Parkinson's disease</subject><subject>Patient Compliance - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Tablets</subject><subject>Wearing-off</subject><issn>0300-7995</issn><issn>1473-4877</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><recordid>eNp10c9rFTEQB_AgFvus_gFeJLee1iY7u90EvJTiLyjYg56X2WRCo_uSNZPX0n_Cv9ltXxVBe8pAPvMdmBHilVZvtDb9iQKlBmu1UjAYddqaJ2KjuwGazgzDU7G5-29W0B-K58zflNKtsfaZOGxV11qj7Ub8PPNXVCg5kjexXsmZrrPPC544LFO8ryhVdLjkRPKaCu_4P0hi8vIviCyZFixYSVacZqosY5IL1rgq3s-6xPI9Js7pmKWPTMj0QhwEnJlePrxH4uv7d1_OPzYXnz98Oj-7aBz0UBvA0GtEN1FH3oKCU0eTURZsgG6CELy1ZjCOQu-11R46622YwgRt54zRcCSO97lLyT92xHXcRnY0z5go73gcAKBT_WBWqffSlcxcKIxLiVsst6NW490Vxn-usPa8fkjfTVvyfzp-r30Fb_cgppDLFm9ymf1Y8XbOJRRMLvIIj-f_Al51mS8</recordid><startdate>20100701</startdate><enddate>20100701</enddate><creator>Delea, Thomas E.</creator><creator>Thomas, Simu K.</creator><creator>Hagiwara, May</creator><creator>Mancione, L.</creator><general>Taylor & Francis</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100701</creationdate><title>Adherence with levodopa/carbidopa/entacapone versus levodopa/carbidopa and entacapone as separate tablets in patients with Parkinson's disease</title><author>Delea, Thomas E. ; Thomas, Simu K. ; Hagiwara, May ; Mancione, L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c353t-3af51aacbe4ed93036ceb80939f34b3ffd99878cef5d191d349d9fbfb324c8813</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adherence</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Algorithms</topic><topic>Antiparkinson Agents - administration & dosage</topic><topic>Antiparkinson Agents - adverse effects</topic><topic>Carbidopa - administration & dosage</topic><topic>Carbidopa - adverse effects</topic><topic>Catechols - administration & dosage</topic><topic>Catechols - adverse effects</topic><topic>Cohort Studies</topic><topic>Dosage Forms</topic><topic>Drug Combinations</topic><topic>Female</topic><topic>Humans</topic><topic>Levodopa - administration & dosage</topic><topic>Levodopa - adverse effects</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Motor complications</topic><topic>Nitriles - administration & dosage</topic><topic>Nitriles - adverse effects</topic><topic>Parkinson Disease - drug therapy</topic><topic>Parkinson Disease - epidemiology</topic><topic>Parkinson's disease</topic><topic>Patient Compliance - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Tablets</topic><topic>Wearing-off</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Delea, Thomas E.</creatorcontrib><creatorcontrib>Thomas, Simu K.</creatorcontrib><creatorcontrib>Hagiwara, May</creatorcontrib><creatorcontrib>Mancione, L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Current medical research and opinion</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Delea, Thomas E.</au><au>Thomas, Simu K.</au><au>Hagiwara, May</au><au>Mancione, L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adherence with levodopa/carbidopa/entacapone versus levodopa/carbidopa and entacapone as separate tablets in patients with Parkinson's disease</atitle><jtitle>Current medical research and opinion</jtitle><addtitle>Curr Med Res Opin</addtitle><date>2010-07-01</date><risdate>2010</risdate><volume>26</volume><issue>7</issue><spage>1543</spage><epage>1552</epage><pages>1543-1552</pages><issn>0300-7995</issn><eissn>1473-4877</eissn><abstract>Observational studies suggest that single-tablet formulations are associated with improved adherence versus the same components taken as separate tablets. The objective of this study was to compare adherence in patients with Parkinson's disease (PD) receiving levodopa therapy as levodopa/carbidopa/entacapone tablets (LCE) versus levodopa/carbidopa (LC) tablets and entacapone (E) as separate tablets (LC and E).
This was a retrospective, observational cohort study using a large health insurance claims database. Subjects included persons with a PD diagnosis who were receiving LC without E and then received either an add-on therapy with E as a separate tablet (LC and E) or LCE as one tablet (LCE). The primary study outcome was treatment adherence, estimated from pharmacy refills based on the 'percent of days covered' (PDC) with LCE or LC and E during follow-up and compared for patients receiving LCE and LC and E using multivariate regression analyses.
In multivariate analyses controlling for differences between groups in baseline characteristics, including pre-index dosage of and adherence with LC, receipt of LCE (n = 388) was associated with 79% lower mean non-adherence during follow-up (95% CI: 73-83%; p < 0.001) versus LC and E (n = 823), 86% lower odds of unsatisfactory adherence (95% CI: 80-91%; p < 0.001), and a 26% lower risk of discontinuation (95% CI: 6-42%; p < 0.013).
This was an observational study with the inherent potential for selection bias. Pharmacy claims may not provide an accurate estimate of adherence. Requiring subjects to have a certain number of prescriptions before and after the index date may yield a sample that is not representative of all patients initiating levodopa therapy in typical clinical practice.
Better adherence with LCE may have important implications for maintaining function in patients receiving chronic oral levodopa therapy. Further research is needed to confirm these results and examine the association between improved adherence and clinical and economic outcomes.</abstract><cop>England</cop><pub>Taylor & Francis</pub><pmid>20429819</pmid><doi>10.1185/03007991003780628</doi><tpages>10</tpages></addata></record> |
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| ispartof | Current medical research and opinion, 2010-07, Vol.26 (7), p.1543-1552 |
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| language | eng |
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| source | Taylor and Francis:Jisc Collections:Taylor and Francis Read and Publish Agreement 2024-2025:Medical Collection (Reading list) |
| subjects | Adherence Aged Aged, 80 and over Algorithms Antiparkinson Agents - administration & dosage Antiparkinson Agents - adverse effects Carbidopa - administration & dosage Carbidopa - adverse effects Catechols - administration & dosage Catechols - adverse effects Cohort Studies Dosage Forms Drug Combinations Female Humans Levodopa - administration & dosage Levodopa - adverse effects Male Middle Aged Motor complications Nitriles - administration & dosage Nitriles - adverse effects Parkinson Disease - drug therapy Parkinson Disease - epidemiology Parkinson's disease Patient Compliance - statistics & numerical data Retrospective Studies Tablets Wearing-off |
| title | Adherence with levodopa/carbidopa/entacapone versus levodopa/carbidopa and entacapone as separate tablets in patients with Parkinson's disease |
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