| Improvement in secondary hyperparathyroidism due to drug adherence monitoring in dialysis patients. | |
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MedLine Citation:
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PMID: 19761725 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Poor medication adherence is a frequent cause of treatment failure but is difficult to diagnose. In this study we have evaluated the impact of measuring adherence to cinacalcet-HCl and phosphate binders in dialysis patients with uncontrolled secondary hyperparathyroidism. METHODS: 7 chronic dialysis patients with iPTH-levels >= 300 pg/ml despite treatment with >= 60 mg cinacalcet-HCl were included. Medication adherence was measured using the "Medication Events Monitoring System" during 3 months, followed by another 3-month period without monitoring. The adherence results were monthly discussed with the patients, as well as strategies to improve them. RESULTS: During monitoring, the percentage of prescribed doses taken was higher for cinacalcet-HCl (87.4%) and sevelamer (86.3%) than for calcium acetate (76.1%), as was the taking adherence (81.9% vs. 57.3% vs. 49.1%) but not the percentage of drug holidays (12.3% vs. 4.5% vs. 3.6%). Mean PO4 levels (from 2.24 +/- 0.6 mmol/l to 1.73 +/- 0.41 mmol/l; p = 0.14) and Ca++ x PO4 product (4.73 +/- 1.43 to 3.41 +/- 1.04 mmol2/l2; p = 0.12) improved and iPTH-level improved significantly from 916 +/- 618 pg/ml to 442 +/- 326 pg/ml (p = 0.04), without any change in medication. However, as drug monitoring was interrupted, all laboratory parameters worsened again. CONCLUSIONS: Assessment of drug adherence helped to document episodes of non-compliance and helped to avoid seemingly necessary dose increases. |
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Authors:
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M Pruijm; D Teta; G Halabi; G Wuerzner; V Santschi; M Burnier |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Clinical nephrology Volume: 72 ISSN: 0301-0430 ISO Abbreviation: Clin. Nephrol. Publication Date: 2009 Sep |
Date Detail:
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Created Date: 2009-09-18 Completed Date: 2009-12-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0364441 Medline TA: Clin Nephrol Country: Germany |
Other Details:
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Languages: eng Pagination: 199-205 Citation Subset: IM |
Affiliation:
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Service of Nephrology and Hypertension, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Female Humans Hyperparathyroidism, Secondary / drug therapy* Male Middle Aged Naphthalenes / therapeutic use* Patient Compliance / statistics & numerical data* Prospective Studies Renal Dialysis* |
| Chemical | |
Reg. No./Substance:
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0/Naphthalenes; 364782-34-3/cinacalcet |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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