Early (1-year) Discontinuation of Different Anti- XXXX Medications Compared: A Population-Based Cohort Study.

@entity1 @entity171 @entity15896 @entity561 @entity170 @entity562 @entity204
Although a number of reports suggest very low persistence with oral @entity171 , there is limited data on persistence with other anti- @entity170 medications. We compare rates of early discontinuation (in the first year) with all available outpatient anti- @entity170 drugs in Catalonia, Spain. We conducted a population-based retrospective cohort study using data from the SIDIAP database. SIDIAP contains computerized primary care records and pharmacy dispensing data for >80 % of the population of Catalonia (>5 million @entity1 ). All SIDIAP @entity1 starting an anti- @entity170 drug between 1/1/2007 and 30/06/2011 (with 2 years wash-out) were included. We modelled persistence as the time between first prescription and therapy discontinuation (refill gap of at least 6 months) using Fine and Gray survival models with competing risk for @entity204 . We identified 127,722 @entity1 who started any anti- @entity170 drug in the study period. The most commonly prescribed drug was weekly @entity561 (N = 55,399). 1-Year persistence ranges from 40 % with monthly @entity562 to 7.7 % with daily @entity562 , and discontinuation was very common [from 49.5 % (monthly @entity562 ) to 84.4 % (daily @entity562 )] as was also switching in the first year of therapy [from 2.8 % (weekly @entity561 ) to 10 % (daily @entity561 )]. Multivariable-adjusted models showed that only monthly @entity562 had better one-year persistence than weekly @entity561 and @entity15896 equivalent, whilst all other therapies had worse persistence. Early discontinuation with available anti- @entity170 oral drugs is very common. Monthly @entity562 , weekly @entity561 , and daily @entity15896 are the drugs with the best persistence, whilst daily oral drugs have 40-60 % higher first-year discontinuation rates compared to weekly @entity561 .
