Drug holiday - Where to, this year?

At DoryHealth, we have one foot ???? in the field, to best understand our clients and partners; and one foot in medical literature ??, where we systematically browse the research on factors behind (non-)adherence. This information usually flows straight into our development …

…but why keep it to ourselves?

We’d thought we’d share a couple of findings with you, starting with a hot topic: drug-holiday???

So what is a drug holiday? In short, it’s when a patient ceases to take her/his medication correctly over a certain duration of time. [1] defines it as “no medication intake for >36h or 60h depending on the daily dosing regimen”.??, for instance. [4] reminds us that nonadherence includes not taking doses on time, missing doses, taking extra doses to compensate for missed doses and ... drug holidays.

Is drug holiday a thing? Well, [2] looks at the drug-holidays of children around 11-15 years old with type 1 Diabetes, and identifies a 19% drop in adherence during school holidays, and a 26% drop during weekends or public holidays, for instance. [3] follows osteoporosis patients and notes that 71% of the patients took a holiday of >3 days, with a slightly lower adherence on Fridays ?? and weekends.

These figures from [3] illustrate the impact on adherence of drug holidays, and intake time. Feel free to use it to tease your friends who are early risers...

And…what’s the issue with drug-holiday? According to [4], nonadherence has a negative impact on treatment safety and efficacy, with a risk of developing drug resistance. It points to [5], where it is stated that drug holiday may increase ??the risk of kidney damage, with effects proportional of the drug holiday duration and the missed doses. [2] then underlines the significance of holidays and weekends (25% and 30% respectively) before reminding that a 25% reduction in adherence is linked to significant increases in hospitalization and mortality in adults. ??

So while we hope that you are soon headed to a sunny beach, a picturesque mountain, or a coral reef, we also hope that you’ll remember that treatments can’t afford a holiday.

[1] DeGeest S, 2006, Supporting medication adherence in renal transplantation (SMART): a pilot RCT to improve adherence to immunosuppressive regimens, Clin Transplant 2006: 20: 359-368

[2] Legget C, 2019, Adherence to metformin is reduced during school holidays and weekends in children with type 1 diabetes, Arch Dis Child 2019; 104:890-894

[3] Touskova T, 2015, Drug holidays: the most frequent type of noncompliance with calcium plus vitamin D supplementation in persistent patients with osteoporosis, Patient Preference and Adherence 2015:9: 1771-1779,

[4] Vrijens B, 2019, A Six Sigma framework to successfully manage medication, British Pharmacological Society, 85(8): 1661–1663

[5] Hill-McManus D, 2018, Impact of non-adherence on the safety and efficacy of uric acid lowering therapies in the treatment of gout, Br J Clin Pharmacol. 2018;85:142-152