title: Pattern of timing adherence could guide recommendations for personalized intake schedules.
abstract: Deviations in execution from the prescribed drug intake schedules (timing non adherence) are frequent and may pose a substantial risk for therapeutic failure. Simple methods to monitor timing adherence with multiple drugs are missing. A new technology, i.e., the polymedication electronic monitoring system (POEMS) attached to a multidrug punch card, was used in a clinical trial on outpatients with prescribed medicines for vascular risk reduction. The complete delineation of timing adherence allows for the calculation of objective adherence parameters and the linking of exposure with drug-drug interactions. A sub-analysis was performed on 68 patients, who were prescribed lipid lowering therapy. A smaller intake time variability of the lipid lowering drug was significantly associated with better levels of LDL-cholesterol, independently of the time of day. This finding may challenge current general recommendations for the timing of lipid lowering drugs' intake and substantiate that inter-individual differences in timing adherence may contribute to response variability. Thus, objective parameters based on multidrug adherence monitoring should be considered as independent variables in personalized medicine. In clinical practice, personalized intake recommendations according to patients' pattern of timing adherence may help to optimize the effectiveness of lipid lowering agents.
authors.affiliation: Pharmaceutical Care Research Group, Department of Pharmaceutical Sciences, University of Basel, Pharmazentrum, Klingelbergstrasse 50, CH-4056 Basel, Switzerland. philipp.walter@unibas.ch.
authors.forename: Philipp
authors.initials: P
authors.lastname: Walter
authors.affiliation: Pharmaceutical Care Research Group, Department of Pharmaceutical Sciences, University of Basel, Pharmazentrum, Klingelbergstrasse 50, CH-4056 Basel, Switzerland. isabelle.arnet@unibas.ch.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Arnet
authors.affiliation: Vascular Risk Foundation VARIFO, Ziegelfeldstrasse 1, CH-4600 Olten, Switzerland. info@kardiolab.ch.
authors.forename: Michel
authors.initials: M
authors.lastname: Romanens
authors.affiliation: Diagnostic Hematology, University Hospital of Basel, Petersgraben 4, CH-4031 Basel, Switzerland. TsakirisD@uhbs.ch.
authors.forename: Dimitrios A
authors.initials: DA
authors.lastname: Tsakiris
authors.affiliation: Pharmaceutical Care Research Group, Department of Pharmaceutical Sciences, University of Basel, Pharmazentrum, Klingelbergstrasse 50, CH-4056 Basel, Switzerland. kurt.hersberger@unibas.ch.
authors.forename: Kurt E
authors.initials: KE
authors.lastname: Hersberger