1. Using a learning health system to understand the mismatch between medicines supply and actual medicines use among adults with cystic fibrosis
- Author
-
Jayne Faulkner, Jack Johnson, Carys Jones, Jill Taylor, Simon Range, Pauline Whelan, K. Bateman, Dimah Sweis, Thomas V. Daniels, S. Dawson, Nikki Totton, Helen Dunn, Harriet Gledhill, C. Girling, Elizabeth Shepherd, Darren Tature, Amanda Plummer, Angharad Lawson, Amanda Bevan, Penny Galey, Stephen Bourke, David Waine, Helen L. Barr, Jessica Gadsby, F P Edenborough, Louise Warnock, Michael Martin, Misbah Tahir, John Ainsworth, C. Carolan, Chandra Ohri, Annant Damani, Rebecca Thomas, Stephen Morrow, J.A. Nightingale, Peter Moran, Giles Fitch, Steven Antrobus, David Derry, Christopher Orchard, Jane Dewar, Heather Seabridge, Bryony Miller, William G Flight, Dejene Shiferaw, Sarah Poole, Tracey Daniels, Mark C. Pasteur, Zhe Hui Hoo, Martin J Wildman, Katy Lee, Josie Cunningham, Iain Buchan, Mark I. Allenby, Mary P. Carroll, Alan Anderson, N.J. Bell, Marlene Hutchings, Rachael Curley, Alexandra Higton, Simon Doe, Nicki Bush, India R. Davids, Angela McGowan, Gauri Saini, Michelle Thomas, Carlos Echevarria, and Nicola Robson
- Subjects
Adult ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Cystic Fibrosis ,Electronic data capture ,business.industry ,Nebulizers and Vaporizers ,Mean age ,Learning Health System ,medicine.disease ,Cystic fibrosis ,Medication Adherence ,Medication possession ratio ,Cross-Sectional Studies ,Internal medicine ,Pediatrics, Perinatology and Child Health ,Cost analysis ,Humans ,Medicine ,Female ,business ,Medicine use ,Retrospective Studies ,Actual use - Abstract
Background\ud \ud Studies in separate cohorts suggest possible discrepancies between inhaled medicines supplied (median 50-60%) and medicines used (median 30-40%). We performed the first study that directly compares CF medicine supply against use to identify the cost of excess medicines supply.\ud \ud \ud \ud Methods\ud \ud This cross-sectional study included participants from 12 UK adult centres with ≥1 year of continuous adherence data from data-logging nebulisers. Medicine supply was measured as medication possession ratio (MPR) for a 1-year period from the first suitable supply date. Medicine use was measured as electronic data capture (EDC) adherence over the same period. The cost of excess medicines was calculated as whole excess box(es) supplied after accounting for the discrepancy between EDC adherence and MPR with 20% contingency.\ud \ud \ud \ud Results\ud \ud Among 275 participants, 133 (48.4%) were females and mean age was 30 years (95% CI 29-31 years). Median EDC adherence was 57% (IQR 23-86%), median MPR was 74% (IQR 46-96%) and the discrepancy between measures was median 14% (IQR 2-29%). Even with 20% contingency, mean potential cost of excess medicines was £1,124 (95% CI £855-1,394), ranging from £183 (95% CI £29-338) for EDC adherence ≥80% to £2,017 (95% CI £1,507-2,526) for EDC adherence
- Published
- 2022