Factors associated with physicians’ prescriptions for rheumatoid arthritis drugs not filled by patients
Abstract Background This study estimated the extent and predictors of primary nonadherence (i.e., prescriptions made by physicians but not initiated by patients) to methotrexate and to biologics or tofacitinib in rheumatoid arthritis (RA) patients who were newly prescribed these medications. Methods...
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doaj-a956dbfba0914a4ea36cdc2637bd19ff2020-11-24T20:58:33ZengBMCArthritis Research & Therapy1478-63622018-05-0120111210.1186/s13075-018-1580-5Factors associated with physicians’ prescriptions for rheumatoid arthritis drugs not filled by patientsHong J. Kan0Kirill DyagilevPeter Schulam1Suchi Saria2Hadi Kharrazi3David Bodycombe4Charles T. Molta5Jeffrey R. Curtis6Center for Population Health IT, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public HealthComputer Science Department, Johns Hopkins UniversityComputer Science Department, Johns Hopkins UniversityCenter for Population Health IT, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public HealthCenter for Population Health IT, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public HealthMain Line Rheumatology, Lankenau Medical CenterDivision of Clinical Immunology and Rheumatology, University of Alabama at BirminghamAbstract Background This study estimated the extent and predictors of primary nonadherence (i.e., prescriptions made by physicians but not initiated by patients) to methotrexate and to biologics or tofacitinib in rheumatoid arthritis (RA) patients who were newly prescribed these medications. Methods Using administrative claims linked with electronic health records (EHRs) from multiple healthcare provider organizations in the USA, RA patients who received a new prescription for methotrexate or biologics/tofacitinib were identified from EHRs. Claims data were used to ascertain filling or administration status. A logistic regression model for predicting primary nonadherence was developed and tested in training and test samples. Predictors were selected based on clinical judgment and LASSO logistic regression. Results A total of 36.8% of patients newly prescribed methotrexate failed to initiate methotrexate within 2 months; 40.6% of patients newly prescribed biologics/tofacitinib failed to initiate within 3 months. Factors associated with methotrexate primary nonadherence included age, race, region, body mass index, count of active drug ingredients, and certain previously diagnosed and treated conditions at baseline. Factors associated with biologics/tofacitinib primary nonadherence included age, insurance, and certain previously treated conditions at baseline. The area under the receiver operating characteristic curve of the logistic regression model estimated in the training sample and applied to the independent test sample was 0.86 and 0.78 for predicting primary nonadherence to methotrexate and to biologics/tofacitinib, respectively. Conclusions This study confirmed that failure to initiate new prescriptions for methotrexate and biologics/tofacitinib was common in RA patients. It is feasible to predict patients at high risk of primary nonadherence to methotrexate and to biologics/tofacitinib and to target such patients for early interventions to promote adherence.http://link.springer.com/article/10.1186/s13075-018-1580-5Rheumatoid arthritisPrimary nonadherenceDisease-modifying anti-rheumatic drugsMethotrexateBiologicsPredictive modeling |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hong J. Kan Kirill Dyagilev Peter Schulam Suchi Saria Hadi Kharrazi David Bodycombe Charles T. Molta Jeffrey R. Curtis |
spellingShingle |
Hong J. Kan Kirill Dyagilev Peter Schulam Suchi Saria Hadi Kharrazi David Bodycombe Charles T. Molta Jeffrey R. Curtis Factors associated with physicians’ prescriptions for rheumatoid arthritis drugs not filled by patients Arthritis Research & Therapy Rheumatoid arthritis Primary nonadherence Disease-modifying anti-rheumatic drugs Methotrexate Biologics Predictive modeling |
author_facet |
Hong J. Kan Kirill Dyagilev Peter Schulam Suchi Saria Hadi Kharrazi David Bodycombe Charles T. Molta Jeffrey R. Curtis |
author_sort |
Hong J. Kan |
title |
Factors associated with physicians’ prescriptions for rheumatoid arthritis drugs not filled by patients |
title_short |
Factors associated with physicians’ prescriptions for rheumatoid arthritis drugs not filled by patients |
title_full |
Factors associated with physicians’ prescriptions for rheumatoid arthritis drugs not filled by patients |
title_fullStr |
Factors associated with physicians’ prescriptions for rheumatoid arthritis drugs not filled by patients |
title_full_unstemmed |
Factors associated with physicians’ prescriptions for rheumatoid arthritis drugs not filled by patients |
title_sort |
factors associated with physicians’ prescriptions for rheumatoid arthritis drugs not filled by patients |
publisher |
BMC |
series |
Arthritis Research & Therapy |
issn |
1478-6362 |
publishDate |
2018-05-01 |
description |
Abstract Background This study estimated the extent and predictors of primary nonadherence (i.e., prescriptions made by physicians but not initiated by patients) to methotrexate and to biologics or tofacitinib in rheumatoid arthritis (RA) patients who were newly prescribed these medications. Methods Using administrative claims linked with electronic health records (EHRs) from multiple healthcare provider organizations in the USA, RA patients who received a new prescription for methotrexate or biologics/tofacitinib were identified from EHRs. Claims data were used to ascertain filling or administration status. A logistic regression model for predicting primary nonadherence was developed and tested in training and test samples. Predictors were selected based on clinical judgment and LASSO logistic regression. Results A total of 36.8% of patients newly prescribed methotrexate failed to initiate methotrexate within 2 months; 40.6% of patients newly prescribed biologics/tofacitinib failed to initiate within 3 months. Factors associated with methotrexate primary nonadherence included age, race, region, body mass index, count of active drug ingredients, and certain previously diagnosed and treated conditions at baseline. Factors associated with biologics/tofacitinib primary nonadherence included age, insurance, and certain previously treated conditions at baseline. The area under the receiver operating characteristic curve of the logistic regression model estimated in the training sample and applied to the independent test sample was 0.86 and 0.78 for predicting primary nonadherence to methotrexate and to biologics/tofacitinib, respectively. Conclusions This study confirmed that failure to initiate new prescriptions for methotrexate and biologics/tofacitinib was common in RA patients. It is feasible to predict patients at high risk of primary nonadherence to methotrexate and to biologics/tofacitinib and to target such patients for early interventions to promote adherence. |
topic |
Rheumatoid arthritis Primary nonadherence Disease-modifying anti-rheumatic drugs Methotrexate Biologics Predictive modeling |
url |
http://link.springer.com/article/10.1186/s13075-018-1580-5 |
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