Device Usability and Compliance: The Implications, Opportunities and Requirements
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Andy Fry and Julian Dixon presented during the Parenteral Drug Association's (PDA) Prefilled Syringes SIG in March 2011 on the hot topic of device usability and compliance.
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Device Usability and Compliance: The Implications, Opportunities and Requirements
- 1. Device Usability and Compliance: The Implications, Opportunities and Requirements Andy Fry, Founder Julian Dixon, Head of User Research 24 th March 2011 www.team-consulting.com © Team Consulting 2011 PDA Europe IGM PFS – Team Presentation, slide
- 2. Compliance – some research data www.team-consulting.com © Team Consulting 2011 PDA Europe IGM PFS – Team Presentation, slide 1 - Haynes et al (1979) Compliance in health care . Johns Hopkins University Press, 1979 2 - Paes et al (1997) Impact of dosage frequency on patient compliance. Diabetes Care 20:1512 -1517 3 - Viller et al (1999) Compliance to drug treatment of patients with rheumatoid arthritis: a 3 year longitudinal study. J Rheumatol 10: 2114-22 4 - Hetland et (2010) Arthritis & Rheumatism 62: 22–32 5 - Cramer et al (2007) A systematic review of persistence and compliance with bisphosphonates for osteoporosis. Osteoporos Int 18:1023–103 50% estimated compliance across chronic illnesses & lifestyle changes 1 measured compliance with oral medications for Type 2 diabetes 2 53% to 67% 30% to 35% compliance with oral methotrexate for RA 3 compliance with inflximab infusion for RA 4 41% 52% compliance with adalimumab autoinjector for RA 4 25% to 35% compliance with daily oral bisphosphonate for osteoporosis 5 35% to 45% compliance with weekly oral bisphosphonate for osteoporosis 5 change delivery route reduce dose freq side effects
- 12. www.team-consulting.com © Team Consulting 2011 PDA Europe IGM PFS – Team Presentation, slide www.team-consulting.com © Team Consulting 2010 For further information, please contact Andy Fry Tel: +44 (0)1799 532739 e-mail: [email_address] Julian Dixon Tel: +44 (0)1799 532746 e-mail: [email_address] Team Consulting Ltd Abbey Barns, Duxford Road Ickleton, Cambridge CB10 1SX, UK Tel:+44 (0)1799 532 700 Fax:+44 (0)1799 532 701 Email: info@team-consulting.com
Notas del editor
- It has been generally acknowledged for years that non-adherence rates for chronic illness regimens and for lifestyle changes are ∼ 50% Haynes et al (1979) Compliance in health care . Johns Hopkins University Press, 1979 Adherence to oral medications (e.g. sulfonylurea) in patients with type 2 diabetes = 53% - 67% when measured by electronic monitoring Paes et al (1997) Impact of dosage frequency on patient compliance. Diabetes Care 20:1512 -1517 Factors affecting adherence Demographic factors; poor education = reduced adherence Psychological factors; patients adhere well when treatment makes sense to them, when it seems effective Social factors; robust social support (family, HCP) = better compliance Disease- and treatment-related factors; lower regimen adherence can be expected when a health condition is chronic Rheumatoid arthritis 30% - 35% complete compliance at 3 years [predominantly] on weekly oral methotrexate treatment Factors : “good compliance” factors: older age > female sex > decreased disability > +ve rel’ship with HCP > patient understanding of disease Viller et al (1999) Compliance to drug treatment of patients with rheumatoid arthritis: a 3 year longitudinal study. J Rheumatol 10: 2114-22 !!! “Unadjusted” (?) 4 year drug adherence rates for Humira adalimumab (i.e. autoinjector) = 52%; for infliximab (i.e infusion) = 41% … NICE DATA …showing improvement in compliance arguably due to delivery technology Hetland et (2010) ARTHRITIS & RHEUMATISM 62: 22–32 Osteoporosis 25%-35% complete compliance at 1 year on daily oral bisphosphonate therapy; rising to has 35% and 45% for weekly dosing Cramer et al (2007) A systematic review of persistence and compliance with bisphosphonates for osteoporosis. Osteoporos Int 18:1023–103 Factors: “ Wilful non-compliance”: adverse effects (e.g. gastric upset from an oral bisphosphonate) > psychological (low perceived risk of fracture / sceptical of effectiveness of medication) > treatment cost “ Unintentional non-compliance”: Lack of perceived ability to take the medication as prescribed > complex dosing schedules > lack of social support / aid their medication use activities > forgetting to take the medication Silvermann et al (2010) Oral bisphosphonate compliance and persistence: a matter of choice? Osteoporos Intenrational 22: 21-26