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Carole Bandiera,1– 3 Jérôme Pasquier,3 Isabella Locatelli,3 Anne Niquille,2,3 Grégoire Wuerzner,4 Jennifer Dotta-Celio,3 Anna Hachfeld,5 Gilles Wandeler,5 Anna Dorothea Wagner,6 Chantal Csajka,1,2,7 Anne Zanchi,4,8 Matthias Cavassini,9 Marie P Schneider1,2 1School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland; 2Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland; 3Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland; 4Service of Nephrology and Hypertension, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; 5Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland; 6Service of Oncology, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; 7Center for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; 8Service of Endocrinology, Diabetes and Metabolism, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; 9Service of Infectious Diseases, Department of Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, SwitzerlandCorrespondence: Marie P Schneider, School of Pharmaceutical Sciences, University of Geneva, Rue Michel Servet 1, Geneva, 1211, Switzerland, Tel + 41 22 379 53 16, Email Marie.Schneider@unige.chBackground: 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.Keywords: SARS-CoV-2, COVID-19, medication adherence, patient compliance, implementation adherence, electronic adherence monitoring, interprofessional adherence intervention

La non-adhésion médicamenteuse (=le processus selon lequel le comportement des patient·es s’écarte de la prescription médicale) est prévalente chez les patient·es atteint·es de maladies chroniques. Le programme interprofessionnel d'adhésion aux médicaments (IMAP) vise à soutenir l'adhésion médicamenteuse (=l’implémentation et la persistance) grâce à une technologie numérique interactive (le pilulier électronique) fournissant un feedback sur le comportement du/de la patient·e, des entretiens motivationnels réguliers de 15 minutes entre le/la patient·e et le/la pharmacien·ne, et un rapport sur l’adhésion médicamenteuse partagé au/à la médecin et au/à l'infirmièr·e. Par le biais de deux essais randomisés et contrôlés intégrés dans la pratique de routine, cette thèse a évalué l'impact de l'IMAP sur l'adhésion médicamenteuse i) chez des patient·es atteint·es de cancers solides traité·es par inhibiteurs des protéines kinases (IPK) (étude OpTAT) et ii) chez des patient·es atteint·es de néphropathie diabétique (étude PANDIA-IRIS). Alors que la pandémie COVID- 19 a frappé la recherche en 2020, l'adhésion médicamenteuse a été investiguée pendant le confinement (étude CovADH). Cette thèse a montré que l'IMAP soutient, améliore et maintient l’implémentation médicamenteuse chez les patient·es atteint·es de cancers solides et chez les patient·es atteint·es de néphropathie diabétique. La collaboration interprofessionnelle devrait être davantage renforcée pour optimiser le recrutement, l'engagement et la rétention des patient·es dans les programmes cognitivo-comportementaux tels que l'IMAP. La définition des rôles et des responsabilités des professionnel·les de la santé, et le développement de compétences complémentaires participeront à combler le fossé entre les sciences cliniques et comportementales. Dans cette perspective, et pour la première fois, le policy brief suisse ENABLE (European Network to Advance Best practices & technoLogy on medication adherence) que nous venons de publier contient toutes les informations nécessaires pour influencer les politiques et les pratiques en Suisse afin d’implémenter les interventions de soutien de l’adhésion médicamenteuse au niveau national en tant que standard des soins.

Refereed/Peer-reviewed Not monitoring adherence to oral anticancer therapies (OAT) can lead to poor clinical outcomes, including premature death as reported by Foulon et al. (Acta Clin Belg 66(2):85–96, 2011) and Greer et al. (Oncologist 21(3):354–76, 2016). Barriers to the implementation of supportive cancer care interventions in medication adherence occur with multiple hospital sites, cancer diagnoses, and numerous healthcare professionals. This commentary describes challenges and strategies from two OAT adherence trials in Australia and Switzerland to assist researchers in the design and implementation of future interprofessional trials.