Effect of Missed Doses on the Therapeutic Effect of Methotrexate for Rheumatoid Arthritis: A Pharmacokinetic Modeling Study.

Introduction: Patients rarely, if ever, take their medications exactly as prescribed. The extent to which missed doses interfere with a drug's therapeutic effect remains unclear.

Methods: After weekly oral dosing of methotrexate (MTX) for rheumatoid arthritis, its polyglutamate derivatives (MTXglu) accumulate in red blood cells, where they are markers for the drug's therapeutic effectiveness.

Patterns of non-adherence to oral antiretroviral medication: frequencies of consecutively missed doses.

Purpose: The therapeutic effect of a once-daily oral drug will be maintained if there are no occurrences of consecutively missed doses that exceed the duration of the drug's effect. The durations of effect of antiretroviral drugs are typically in the range of 1-4 days. Here, we report the observed frequencies of ≥2, ≥3, and ≥4 consecutively missed doses for patients taking a once-daily oral antiretroviral drug for HIV infection.

The Adherence Rate Threshold is Drug Specific.

Introduction: Patient adherence to a medication regimen is usually expressed as an adherence rate, defined as the proportion of prescribed doses actually taken. An adherence rate threshold, above which the therapeutic effect is maintained, is typically assigned an arbitrary value, commonly 0.8.

Relationship Between Adherence Rate Threshold and Drug 'Forgiveness'.

The medication adherence rate (A) is the proportion of prescribed drug doses consumed within a given time period. It is often assumed that there is an adherence rate threshold (A ) at or above which the therapeutic effect of the medication is maintained. Drug forgiveness (F) is the number of consecutive doses that can be missed while still maintaining a therapeutic effect.

Barriers to Treatment for Female Problem Gamblers: A UK Perspective.

There is a paucity of research in the UK which examines problem gambling and that which does exist is mainly quantitative, focuses on male samples and fails to look at treatment seeking populations or obstacles preventing problem gamblers from seeking treatment. This paper presents findings from part of a larger qualitative study that explored the experience of treatment for female problem gamblers. Data were collected using semi-structured interviews with eight women who had received individual cognitive-behavioural therapy in the National Health Service for their gambling problem.

Conceptual framework for outcomes research studies of hepatitis C: an analytical review.

Hepatitis C virus infection is one of the main causes of chronic liver disease worldwide. Until recently, the standard antiviral regimen for hepatitis C was a combination of an interferon derivative and ribavirin, but a plethora of new antiviral drugs is becoming available. While these new drugs have shown great efficacy in clinical trials, observational studies are needed to determine their effectiveness in clinical practice.

Defining medication adherence in individual patients.

Background: The classification of patients as adherent or non-adherent to medications is typically based on an arbitrary threshold for the proportion of prescribed doses taken. Here, we define a patient as pharmacokinetically adherent if the serum drug levels resulting from his/her pattern of medication-taking behavior remained within the therapeutic range.

Methods: We used pharmacokinetic modeling to calculate serum drug levels in patients whose patterns of dosing were recorded by a medication event monitoring system.

A prospective randomized double-blind trial of grape juice antioxidants in men with lower urinary tract symptoms.

Aims: Many patients take alternative medications for their lower urinary tract symptoms (LUTS) either in addition or as a substitute for traditional therapies, despite a lack of clinical data. Grapes products are hypothesized to improve bladder function due to their antioxidant and membrane-protective actions. There is increasing evidence that progression of obstructed bladder dysfunction is related to bladder ischemia, reperfusion injury and free radical damage.