48. Introduction to Pharmionics: The Vagaries in Ambulatory Patients' Adherence to Prescribed Drug Dosing Regimens, and Some of Their Clinical and Economic Consequences

  1. Elizabeth B. Andrews PhD, MPH, FISPE3 and
  2. Nicholas Moore MD, PhD, FRCP(Edin), FISPE4
  1. John Urquhart1 and
  2. Bernard Vrijens2

Published Online: 4 APR 2014

DOI: 10.1002/9781118820186.ch48

Mann's Pharmacovigilance

Mann's Pharmacovigilance

How to Cite

Urquhart, J. and Vrijens, B. (2014) Introduction to Pharmionics: The Vagaries in Ambulatory Patients' Adherence to Prescribed Drug Dosing Regimens, and Some of Their Clinical and Economic Consequences, in Mann's Pharmacovigilance (eds E. B. Andrews and N. Moore), John Wiley & Sons, Ltd, Oxford, UK. doi: 10.1002/9781118820186.ch48

Editor Information

  1. 3

    Vice President, Pharmacoepidemiology and Risk Management, RTI Health Solutions, Research Triangle Park, NC, USA

  2. 4

    Professor of Clinical Pharmacology, Service Hospitalo-Universitaire de Pharmacologie, Bordeaux, France

Author Information

  1. 1

    MWV Healthcare, Visé, Belgium and Palo Alto, California, USA and Department of Bioengineering & Therapeutic Sciences, University of California San Francisco Medical Center, San Francisco, CA, USA

  2. 2

    MWV Healthcare, Visé Belgium; Department of Biostatistics and Medical Informatics, University of Liège, Liège, Belgium

Publication History

  1. Published Online: 4 APR 2014
  2. Published Print: 1 APR 2014

ISBN Information

Print ISBN: 9780470671047

Online ISBN: 9781118820186

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Keywords:

  • ambulatory patients;
  • drug dosing regimens;
  • MEMS® Monitor;
  • pharmionics

Summary

The advent of medicines with unprecedented therapeutic power and economic cost, some of which are indicated for multiyear or lifelong use, and some of which are beset by the problem of emergent drug resistance, has put increasing emphasis on the question of how well or poorly patients actually use prescribed medicines. This chapter presents an introduction to pharmionics, and discusses the consequences caused by the vagaries in ambulatory patients′ adherence to prescribed drug dosing regimens. It discusses three basic patterns that characterize the main deviations from prescribed drug dosing regimens: nonacceptance, drug holidays, and discontinuation. The chapter also discusses taxonomic issues and their relation to analyses of dosing history data. It argues why there can be no single parameter that encompasses all major dosing errors and supports sound quantitative analysis. MEMS Monitor is the first commercially available electronically monitored drug package, and has been in the marketplace since 1988.