Medication Adherence Evaluated Through Electronic Monitors During the 2020 COVID-19 Pandemic Lockdown in Switzerland: A Longitudinal Analysis

Carole Bandiera; Jérôme Pasquier; Isabella Locatelli; Anne Niquille; Grégoire Wuerzner; Jennifer Dotta-Celio; Anna Hachfeld; Gilles Wandeler; Anna Dorothea Wagner; Chantal Csajka; Anne Zanchi; Matthias Cavassini; Marie P Schneider

doi:10.2147/PPA.S377780

Medication Adherence Evaluated Through Electronic Monitors During the 2020 COVID-19 Pandemic Lockdown in Switzerland: A Longitudinal Analysis

Patient Prefer Adherence. 2022 Aug 25:16:2313-2320. doi: 10.2147/PPA.S377780. eCollection 2022.

Authors

Carole Bandiera^{1

2

3}, Jérôme Pasquier³, Isabella Locatelli³, Anne Niquille^{2

3}, Grégoire Wuerzner⁴, Jennifer Dotta-Celio³, Anna Hachfeld⁵, Gilles Wandeler⁵, Anna Dorothea Wagner⁶, Chantal Csajka^{1

2

7}, Anne Zanchi^{4

8}, Matthias Cavassini⁹, Marie P Schneider^{1

2}

Affiliations

¹ School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland.
² Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland.
³ Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
⁴ Service of Nephrology and Hypertension, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
⁵ Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland.
⁶ Service of Oncology, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
⁷ Center for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
⁸ Service of Endocrinology, Diabetes and Metabolism, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
⁹ Service of Infectious Diseases, Department of Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.

Abstract

Background: During the 2020 COVID-19 lockdown, patients included in the Interprofessional Medication Adherence Program (IMAP) in Switzerland continued to use electronic monitors (EMs) that registered daily drug-dose intake. We aimed to understand to what extent patients' medication implementation (ie, the extent to which the patient took the prescribed medicine), measured with EMs, was impacted by the lockdown.

Methods: Patients participating in the IMAP were diagnosed with diabetic kidney disease (DKD), solid cancer, human immunodeficiency virus (HIV) and miscellaneous long-term diseases (MLTD). Patient implementation was defined through a proxy: if all patient EMs were opened at least once daily, implementation was considered active (=1), and no implementation was considered (=0) otherwise. Implementation before (from December 2019 to March 2020), during (March to June 2020) and after (June to September 2020) the lockdown was compared. Subanalyses were performed according to the patients' diseases. Subanalyses were performed in patients who used at least one EM in 2018-2019 during the same periods (defined as winter, spring and summer). The logistic regression models used to estimate medication implementation according to the period were fitted using generalized estimating equations.

Results: In 2020, patient implementation (n = 118) did not differ significantly before versus during (OR = 0.98, 95% CI: 0.84-1.15, p = 0.789) and before versus after (OR = 0.91, 95% CI: 0.79-1.06, p = 0.217) the lockdown. These findings remained stable when separately analyzing the implementation of patients with HIV (n = 61), DKD (n = 25) or MLTD (n = 22). Too few patients with cancer were included (n = 10) to interpret the results. In 2019, the implementation of 61/118 (51.7%) patients was significantly lower during summertime versus wintertime (OR = 0.73, 95% CI: 0.60-0.89, p = 0.002).

Conclusion: Medication implementation remained steady before, during and after the lockdown in 2020. The IMAP before, during and after the lockdown may have supported the adherence of most patients, by ensuring continuity of care during periods of routine disturbances.

Keywords: COVID-19; SARS-CoV-2; electronic adherence monitoring; implementation adherence; interprofessional adherence intervention; medication adherence; patient compliance.

Grants and funding

The Optat study is funded by the Swiss Cancer Research Foundation (grant HSR-4077-11-2016) and the PANDIA-IRIS study by LOA IV fund, managed by curafutura, pharmaSuisse and santésuisse (Switzerland). The funding bodies did not intervene in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.