{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:12:41Z","timestamp":1787724761229,"version":"build-2784847793"},"reference-count":22,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T00:00:00Z","timestamp":1714953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Education, University and Research (Progetti di Ricerca di Rilevante Interesse Nazionale","award":["2017728JPK"],"award-info":[{"award-number":["2017728JPK"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Pirfenidone and Nintedanib have significantly improved the prognosis of patients with idiopathic pulmonary fibrosis (IPF), reducing mortality risk and exacerbations. This study aimed to analyze antifibrotic treatment utilization and its association with clinical outcomes (i.e., acute exacerbation or death) during 2014\u20132021 in newly diagnosed IPF patients, using Healthcare Utilization Databases of the Marche Region, Italy. Methods: The first 12-month adherence to antifibrotic was estimated using the Proportion of Days Covered (PDC), defining adherence as PDC \u2265 75%. State Sequence Analysis over the initial 52 weeks of treatment was used to identify adherence patterns. The role of adherence patterns on acute exacerbations\/death, adjusted by demographic, clinical features, and monthly adherence after the 52-week period (time-dependent variable), was assessed with Cox regression. Results: Among 667 new IPF cases, 296 received antifibrotic prescriptions, with 62.8% being adherent in the first year. Three antifibrotic utilization patterns emerged\u2014high adherence (37.2%), medium adherence (42.5%), and low adherence (20.3%)\u2014with median PDCs of 95.3%, 79.5%, and 18.6%, respectively. These patterns did not directly influence three-year mortality\/exacerbation probability, but sustained adherence reduced risk over time. Conclusions: Good adherence was observed in in this population-based study, emphasizing the importance of continuous antifibrotics therapy over time to mitigate adverse outcomes.<\/jats:p>","DOI":"10.3390\/jcm13092727","type":"journal-article","created":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T14:26:11Z","timestamp":1715005571000},"page":"2727","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Understanding Patterns of Adherence to Antifibrotic Treatment in Idiopathic Pulmonary Fibrosis: Insights from an Italian Prospective Cohort Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4589-3474","authenticated-orcid":false,"given":"Marica","family":"Iommi","sequence":"first","affiliation":[{"name":"Center of Epidemiology, Biostatistics and Medical Information Technology, Universit\u00e0 Politecnica delle Marche, 60126 Ancona, Italy"},{"name":"Department of Biomedical Sciences and Public Health, Universit\u00e0 Politecnica delle Marche, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Gonnelli","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Public Health, Universit\u00e0 Politecnica delle Marche, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Bonifazi","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Public Health, Universit\u00e0 Politecnica delle Marche, 60126 Ancona, Italy"},{"name":"Interstitial Lung Diseases, Pleural Diseases and Bronchiectasis Unit, Azienda Ospedaliero-Universitaria \u201cOspedali Riuniti\u201d, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4414-4789","authenticated-orcid":false,"given":"Andrea","family":"Faragalli","sequence":"additional","affiliation":[{"name":"Center of Epidemiology, Biostatistics and Medical Information Technology, Universit\u00e0 Politecnica delle Marche, 60126 Ancona, Italy"},{"name":"Department of Biomedical Sciences and Public Health, Universit\u00e0 Politecnica delle Marche, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Mei","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Public Health, Universit\u00e0 Politecnica delle Marche, 60126 Ancona, Italy"},{"name":"Interstitial Lung Diseases, Pleural Diseases and Bronchiectasis Unit, Azienda Ospedaliero-Universitaria \u201cOspedali Riuniti\u201d, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Pompili","sequence":"additional","affiliation":[{"name":"Regional Health Agency of Marche, 60121 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2422-6528","authenticated-orcid":false,"given":"Flavia","family":"Carle","sequence":"additional","affiliation":[{"name":"Center of Epidemiology, Biostatistics and Medical Information Technology, Universit\u00e0 Politecnica delle Marche, 60126 Ancona, Italy"},{"name":"Department of Biomedical Sciences and Public Health, Universit\u00e0 Politecnica delle Marche, 60126 Ancona, Italy"},{"name":"Regional Health Agency of Marche, 60121 Ancona, Italy"},{"name":"National Centre for Healthcare Research and Pharmacoepidemiology, 20126 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6943-0602","authenticated-orcid":false,"given":"Rosaria","family":"Gesuita","sequence":"additional","affiliation":[{"name":"Center of Epidemiology, Biostatistics and Medical Information Technology, Universit\u00e0 Politecnica delle Marche, 60126 Ancona, Italy"},{"name":"Department of Biomedical Sciences and Public Health, Universit\u00e0 Politecnica delle Marche, 60126 Ancona, Italy"},{"name":"National Centre for Healthcare Research and Pharmacoepidemiology, 20126 Milan, Italy"},{"name":"Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale di Ricovero e Cura per Anziani, 60121 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.1164\/rccm.202202-0399ST","article-title":"Idiopathic Pulmonary Fibrosis (an Update) and Progressive Pulmonary Fibrosis in Adults: An Official ATS\/ERS\/JRS\/ALAT Clinical Practice Guideline","volume":"205","author":"Raghu","year":"2022","journal-title":"Am. 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