Comparison of different methods to assess tacrolimus concentration intra-patient variability as potential marker of medication non-adherence
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11150%2F22%3A10451063" target="_blank" >RIV/00216208:11150/22:10451063 - isvavai.cz</a>
Alternative codes found
RIV/00216208:11160/22:10451063 RIV/00179906:_____/22:10451063
Result on the web
<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=kd2.Ir0k3Y" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=kd2.Ir0k3Y</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.3389/fphar.2022.973564" target="_blank" >10.3389/fphar.2022.973564</a>
Alternative languages
Result language
angličtina
Original language name
Comparison of different methods to assess tacrolimus concentration intra-patient variability as potential marker of medication non-adherence
Original language description
Background and objective: Non-adherence to tacrolimus commonly manifests as low drug concentrations and/or high intra-patient variability (IPV) of concentrations across multiple measurements. We aimed to compare several methods of tacrolimus IPV calculation and evaluate how well each reflects blood concentration variation due to medication non-adherence in kidney transplant recipients. Methods: This Czech single-center retrospective longitudinal study was conducted in 2019. All outpatients >= 18 years of age, >= 3 months post-transplant, and on tacrolimus-based regimens were approached. After collecting seven consecutive tacrolimus concentrations we asked participating patients to selfreport adherence to immunosuppressants (BAASIS(C) scale). The IPV of tacrolimus was calculated as the medication level variability index (MLVI), the coefficient of variation (CV), the time-weighted CV, and via nonlinearly modeled dose-corrected trough levels. These patient-level variables were analyzed using regression analysis. Detected nonlinearities in the dose-response curve were controlled for by adding tacrolimus dosing and its higher-order terms as covariates, along with self-reported medication adherence levels. Results: Of 243 patients using tacrolimus, 42% (n = 102) reported medication non-adherence. Non-adherence was associated with higher CVs, higher time-weighted CVs, and lower dose-corrected nonlinearly modeled trough levels; however, it was not associated with MLVIs. All of the significant operationalizations suggested a weak association that was similar across the applied methods. Discussion and conclusion: Implementation non-adherence was reflected by higher CV or time-weighted CV and by lower blood concentrations of tacrolimus. As an additional tool for identifying patients at risk for non- adherence, simple IPV calculations incorporated into medical records should be considered in everyday clinical practice.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30104 - Pharmacology and pharmacy
Result continuities
Project
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Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2022
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Frontiers in Pharmacology
ISSN
1663-9812
e-ISSN
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Volume of the periodical
13
Issue of the periodical within the volume
October
Country of publishing house
CH - SWITZERLAND
Number of pages
9
Pages from-to
973564
UT code for WoS article
000877281400001
EID of the result in the Scopus database
2-s2.0-85140823975