• Line Margrethe Storgaard
4. term, Clinical Science and Technology, Master (Master Programme)
Abstract Introduction: Adherence among patients suffering chronic diseases averages only 50% according to WHO which causes poor health outcomes and increased health care costs. Evaluation of technology use should include information about patient adherence and persistence. In this project, it is investigated how adherence and persistence can be quantified in an existing clinical study and whether it is possible to predict adherence and persistence based on subjects' baseline data. Method: A retrospective analysis of 100 COPD patients baseline data and their use of medical technology in a one-year RCT study is performed. Adherence and persistence are evaluated through objective measurements. Patients are classified as adherent /non-adherent from a cut-point of > 80% of the recommended use. The cut-point for persistence equals completed study without interruption of treatment. To find possible predictors of adherence and persistence, Independent t-test, Mann-Whitney U test and Chi-square test are performed to test for differences between subgroups baseline data. Results: Based on the decided cut-points, 52% were classified as adherent while 50% were persistent to treatment. 9/50 (18%) discontinued treatment within the first month and 34/50 (68%) within 6 months. Results indicated that patients from baseline data e.g. smoking status, history of disease and demographic data were comparable by time of inclusion. Therefore, the collected baseline characteristics cannot stand alone to predict which patients are or have the potential to be adherent or persistent for treatment with the medical technology. Discussion: A cut-point of 80% is considered useful for quantification of adherence. Summary evaluations, that are estimated over an aggregate period of time, does not portray trends of technology use through the different phases of the adherence process, thus providing a more uncertain estimate of patient adherence. Continuous monitoring of technology use could contribute with knowledge of the dynamic process. A prospective study design with systematic collection of both subjective and objective monitoring data can be recommended in future studies. Conclusion: It is not possible from patient's baseline data alone, to predict their adherence and persistence to treatment. An evaluation of technology use should include additional aspects and perspectives.
Publication date7 Jun 2018
Number of pages48
ID: 280488888