Anno I – Numero 4 – Dicembre 2020
Comitato scientifico editoriale: Antonio Magi, Pierluigi Bartoletti, Fernando De Benedetto, Giovanbattista Desideri, Francesco Cognetti, Roberto Messina
Editore: Intermedia – Direttore Responsabile: Mauro Boldrini –


THRIVE study protocol: a randomized controlled trial evaluating a web-based app and tailored messages to improve adherence to adjuvant endocrine therapy among women with breast cancer
Andrew J Paladino, Janeane N Anderson, Rebecca A Krukowski, Teresa Waters, Mehmet Kocak, Carolyn Graff, Ryan Blue, Tameka N Jones, Joanne Buzaglo, Gregory Vidal, Lee Schwartzberg, Ilana Graetz

Background: Long-term use of adjuvant endocrine therapy (AET) among women with early-stage, hormone receptor-positive breast cancer significantly reduces the risk of hospitalizations, cancer recurrence, and mortality. AET is associated with adverse symptoms that often result in poor adherence. A web-enabled app offers a novel way to communicate and manage symptoms for women on AET. In a region with significant racial disparities in breast cancer outcomes, our study tests the impact of a web-enabled app that collects and transmits patient-reported symptoms to healthcare teams to facilitate timely and responsive symptom management on medication adherence.

Methods: In this randomized controlled trial, we randomize 300 patients initiating AET to one of three arms: 1) an “App” group (n = 100) that receives weekly reminders to use the THRIVE study app; 2) an “App+Feedback” group (n = 100) that receives weekly reminders and tailored feedback based…
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Telemedicine and support groups could be used to improve adherence to treatment and health‐related quality of life in patients affected by inflammatory skin conditions during the COVID‐19 pandemic
C. Marasca, A. Ruggiero, G. Fontanella, M. Ferrillo, G. Fabbrocini, A. Villani

We read with great interest the recent article by Jakhar et al.1 in Clinical and Experimental Dermatology, which reported the measures that could be used during the COVID‐19 pandemic to allow consultations. In particular, they described the growing importance that telemedicine is having during this emergency, focusing on the use of mobile technology (particularly the use of WhatsApp) as a method to communicate via text and voice messages, photos and videos, which is rapidly expanding within the field of telemedicine.1 We report some of the best strategies and technologies we are using at our outpatient clinic (University of Naples Federico II) during the current pandemic.

Management of both acute and chronic dermatological diseases is always challenging, owing to the variable compliance of patients with the required therapies. Before the current pandemic, we carried out a study among patients with acne, showing the importance of prescribing adequate therapy and of…
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A practical approach to switch from a multiple pill therapeutic strategy to a polypill-based strategy for cardiovascular prevention in patients with hypertension
Coca, Antonio; Kreutz, Reinhold; Manolis, Athanasios J.; Mancia, Giuseppe

Pharmacological treatment recommended by guidelines for very high-risk patients with established cardiovascular disease (CVD) includes lipid-lowering drugs, antihypertensive agents and antiplatelet therapy. Depending on the associated comorbidities, this baseline regimen has to be complemented with other drugs. Therefore, the number of pills to be taken is usually high and adherence to these multiple pill therapeutic regimens and long-term persistence on treatment is low, being the main factor for insufficient control of cardiovascular risk factors. The CNIC (Centro Nacional de Investigaciones Cardiovasculares, Ministerio de Ciencia e Innovación, España) polypill is the only polypill containing low-dose aspirin approved by the EMA and marketed in Europe, and has demonstrated to improve adherence. For this reason, guidelines recommend its use for secondary prevention of CVD, and also for primary prevention of cardiovascular events in patients with multiple cardiovascular risk factors and advanced…

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Randomized Trial of a Smartphone Mobile App to Improve Symptoms and Adherence to Oral Therapy for Cancer
Joseph A. Greer, PhDa,b; Jamie M. Jacobs, PhDa,b; Nicole Pensak, PhDc ; Lauren E. Nisotel, BSd; Joel N. Fishbein, BAe ; James J. MacDonald, BAf ; Molly E. Ream, BAg; Emily A. Walsh, BAa ; Joanne Buzaglo, PhDh ; Alona Muzikansky, MAa,b; Inga T. Lennes, MDa,b; Steven A. Safren, PhDg; William F. Pirl, MDb,i; and Jennifer S. Temel, MDa,b

Background: Patients with cancer are increasingly prescribed oral therapies, bearing greater responsibility for self-management of treatment adherence and adverse events. We conducted a randomized trial to test the use of a smartphone mobile app to improve symptoms and adherence to oral cancer therapy. Materials and Methods: From February 18, 2015, through December 31, 2016, 181 patients with diverse cancers who were prescribed oral therapy were randomized to receive either the smartphone mobile app or standard care. The mobile app included a medication plan with reminders, a symptom-reporting module, and patient education. Primary outcomes were adherence (per electronic pill caps), symptom burden (per MD Anderson Symptom Inventory), and quality of life (per the Functional Assessment of Cancer Therapy–General). Participants also completed self-report measures of medication adherence, anxiety and depression symptoms, social support, quality of care…
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Medication adherence and its determinants in patients after myocardial infarction
Lukasz Pietrzykowski, Piotr Michalski, Agata Kosobucka, Michał Kasprzak, Tomasz Fabiszak, Wioleta Stolarek, Jolanta M. Siller-Matula, and Aldona Kubica

Non-adherence to prescribed medication is a serious limitation of long-term treatment in patients after myocardial infarction (MI), which can be associated with medical, social and economical consequences. Improvement of medication adherence has been shown to be a challenge for healthcare providers. The aim of this study was to evaluate changes in medication adherence and variability of adherence determinants during follow-up in patients after MI. A single-center, cohort observational study was conducted in 225 post-MI patients treated with primary coronary intervention (PCI) (27% women and 73% men) aged 30–91 years. Adherence was defined as availability of evaluated drugs within 1-year after discharge from hospital, based on completed prescriptions data obtained from the National Health Fund. The analysis of therapeutic plan realization (adherence to medication prescribed at discharge from hospital) embraced only reimbursed drugs: ACEIs (ramipril, perindopril), P2Y12 receptor inhibitors (clopidogrel) and statins…

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Disease-Modifying Therapy Adherence and Associated Factors in a National Sample of Medicare Patients With Multiple Sclerosis
Pengxiang Li, PhD, Vrushabh P. Ladage, MHCI, Joseph Berger, MD, Salim Chahin, MD, Mehul Jhaveri, PharmD, Caroline Geremakis, PhD, Jalpa A. Doshi, PhD, Show less


Disease-modifying therapies (DMTs) reduce relapse rates and disability progression for relapsing multiple sclerosis (MS). Although 25% to 30% of all US patients with MS are Medicare beneficiaries, limited information exists on this population. This is the first study using national Medicare data to (1) describe characteristics of patients with MS using DMTs, (2) estimate adherence to DMTs over a 1-year and 3-year follow-up, and (3) examine factors associated with DMT adherence.


This retrospective claims analysis used 2011-2014 100% Medicare files. Monthly adherence to MS DMTs was defined as the proportion of days covered ≥0.80 with any DMT in each month for 1-year (n = 36 593) and 3-year (n = 17 599) follow-up samples of MS DMT users. Generalized estimating equation…
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New approach to blood pressure control: Triple combination pill
Massimo Volpe, Giovanna Gallo , Giuliano Tocci

Blood pressure (BP) control remains insufficient worldwide, mostly due to poor adherence to treatments, clinical inertia, adverse effects and underuse of drug-combination strategies. Monotherapy and its uptitration have been long considered the first-line strategy in the treatment of hypertension, often leading to ineffective, time consuming and frustrating results. On the other hand, several studies have demonstrated that starting and continuing antihypertensive therapy based on a drug combination is associated with a greater reduction of BP, an earlier achievement of therapeutic goals and a higher proportion of patients achieving targets with favorable implications on cardiovascular events…
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