Direct oral anticoagulants are the preferred treatment for stroke patients with atrial fibrillation. Pharmacy dispensing data represent a practical method to identify suboptimal medication adherence. This study investigates whether pharmacy dispensing data are indicative of real-life adherence behavior, using data from 130 patients in the MAAESTRO study (2018–2022) in Basel, Switzerland. This secondary data analysis of the MAAESTRO study (Dietrich, 2024) included patients with electronic monitoring (EM) and dispensing data for 12 months. Patients with at least two refills were included in the analysis. Data analyzed from 50 patients (mean age 76.4 ± 9.1 years, 56.0 % male) included 252 refills with a median of 4 refills per patient. Refill patterns were: all refills on time (40.0 %), erratic refills (36.0 %), and end-gaps >10 days (24.0 %). Mean taking adherence was 89.3 ± 13.7 %. EM data revealed missing days in 82.0 % of patients, with 61.0 % having irregular refill patterns. Matched taking adherence was moderately associated with Delta T over all refills (p = 0.034) and the last refill (p = 0.013). Dispensing data processed with the Delta T method correlate moderately with EM data. The Delta T value for the last two refills shows promise for estimating irregular adherence, suggesting potential for targeted interventions in pharmacy practice.

中文翻译：

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直接口服抗凝剂的药房配药和电子监测数据之间的一致性 - MAAESTRO 研究的二次分析


直接口服抗凝药是中风合并房颤患者的首选治疗方法。药房配药数据代表了识别次优药物依从性的实用方法。本研究使用瑞士巴塞尔 MAAESTRO 研究（2018-2022 年）中 130 名患者的数据，调查药房配药数据是否表明现实生活中的依从行为。 MAAESTRO 研究（Dietrich，2024）的二次数据分析包括 12 个月的电子监测 (EM) 和配药数据的患者。分析中包括至少两次补充的患者。对 50 名患者（平均年龄 76.4 ± 9.1 岁，56.0% 男性）的数据进行分析，包括 252 次补充，平均每位患者 4 次补充。补充模式为：所有按时补充 (40.0 %)、不稳定补充 (36.0 %) 和结束间隙 >10 天 (24.0 %)。平均服用依从率为 89.3 ± 13.7 %。 EM 数据显示 82.0% 的患者缺勤，其中 61.0% 的患者补充模式不规则。匹配服用依从性与所有补充药物 (p = 0.034) 和最后一次补充药物 (p = 0.013) 的 Delta T 呈中等相关。使用 Delta T 方法处理的分配数据与 EM 数据具有适度的相关性。最后两次补充的 Delta T 值显示出估计不规则依从性的希望，这表明在药学实践中进行有针对性的干预的潜力。