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      Retrospective analyses of heartworm ( Dirofilaria immitis) disease and ectoparasite preventive medication compliance in veterinary practices in the USA

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          Abstract

          Background

          Compliance failure with administration of heartworm (HW) disease preventives has been reported as the main contributor to HW disease incidence in medicalized dogs. This study aimed to evaluate purchase compliance with different canine HW preventive products in the USA.

          Methods

          Anonymized transaction data from clinics throughout the USA served as the basis for two retrospective analyses. We first examined the monthly equivalent doses of HW preventive purchases from clinics that had implemented extended-release moxidectin injectables ProHeart ® 6 (PH6) and/or ProHeart ® 12 (PH12) compared to clinics that prescribed monthly HW preventatives (MHWP) only. In the second analysis, the purchase compliance in practices that dispensed only flea and tick (FT) and HW products separately but did not dispense combination products (dual-therapy practices) was compared to the purchase compliance with the combination product Simparica Trio ® (sarolaner, moxidectin, and pyrantel chewable tablets), purchased in clinics having implemented combination therapy in their formulary (combination-therapy practices). In both analyses, the numbers of monthly doses dispensed annually per dog were calculated.

          Results

          Transaction data from 3,539,990 dogs in 4615 practices were included in the first analysis. In dogs administered PH12 or PH6, the numbers of monthly equivalent doses were 12 and 8.1, respectively. In both clinic types, the average annual number of MHWP doses totaled 7.3. In the second analysis, a total of 919 practices were identified as combination-therapy practices and 434 as dual-therapy-only practices. A total of 246,654 dogs (160,854 dogs in dual-therapy practices and 85,800 dogs in combination-therapy practices) were included in the calculation of the average annual number of monthly doses, which totaled 6.8 (HW preventive products) and 4.4 (FT products) in dual-therapy practices compared to 7.2 months for both FT and HW preventives with Simparica Trio ® across both practice types.

          Conclusions

          The injectable HW preventive PH12 is the only product that provides 12 months of heartworm disease prevention in a single veterinarian-administered injection. When choosing a monthly preventive, the combination therapy was associated with a greater purchase compliance compared with FT and HW products being dispensed separately.

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          A checklist for medication compliance and persistence studies using retrospective databases.

          Andrew M Peterson, David P Nau, Joyce Cramer … (2015)
          The increasing number of retrospective database studies related to medication compliance and persistence (C&P), and the inherent variability within each, has created a need for improvement in the quality and consistency of medication C&P research. This article stems from the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) efforts to develop a checklist of items that should be either included, or at least considered, when a retrospective database analysis of medication compliance or persistence is undertaken. This consensus document outlines a systematic approach to designing or reviewing retrospective database studies of medication C&P. Included in this article are discussions on data sources, measures of C&P, results reporting, and even conflict of interests. If followed, this checklist should improve the consistency and quality of C&P analyses, which in turn will help providers and payers understand the impact of C&P on health outcomes.
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            Heartworm 'lack of effectiveness' claims in the Mississippi delta: computerized analysis of owner compliance--2004-2011.

            Clarke E Atkins, Michael J. Murray, Lauren J Olavessen … (2014)
            A retrospective medical record review was conducted to identify factors from veterinary clinic medical records that may have contributed to suspected ineffectiveness of a heartworm preventive product. Patient records of 271 dogs, comprising 301 instances of positive heartworm antigen test results while the dogs were receiving heartworm preventive were evaluated. Nineteen veterinary practices in 17 counties and parishes in Arkansas, Louisiana, Mississippi, and Tennessee participated in the study. Records were selected by the veterinary clinics as representative of cases of suspected lack of effectiveness for a heartworm preventive, and for which an owner satisfaction claim had been filed with the manufacturer. Medical record data were entered into a software program, and a graphic representation was created to facilitate analysis of whether pet owners had purchased sufficient heartworm preventive for the dog to be compliant during the period when infection with Dirofilaria immitis could have led to the positive heartworm antigen test result for that patient ("window of infection"). In 243 (80.7%) cases, there was insufficient heartworm preventive purchased, leading to a gap in protection during the "window of infection". In only five cases (1.7%) there were no purchase lapses or extenuating circumstances (underdosing of medication, multiple purchase gaps outside the established window of infection, or dogs have been diagnosed with heartworm infection more than once during the period studied). Half the cases were from multiple-dog households, and in many of these households, sharing of product between pets was acknowledged. In another 28% of the cases from multiple-dog households, more product was purchased than was needed for one dog, suggesting that the product was being shared between more than one pet. In most cases, there was at least one reason that a dog did not receive sufficient heartworm preventive product, placing the dog at risk of developing an infection with mature heartworms. Several actions were identified that veterinary clinics can take to improve heartworm disease prevention in their patients.
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              ProHeart® 12, a moxidectin extended-release injectable formulation for prevention of heartworm ( Dirofilaria immitis ) disease in dogs in the USA for 12 months

              Tom L McTier, Kristina Kryda, Martha Wachowski … (2019)
              Background The efficacy of an extended-release injectable moxidectin (0.5 mg/kg) suspension (ProHeart® 12) (PH 12) in preventing the development of Dirofilaria immitis in dogs for 12 months was investigated in laboratory and field studies in the USA. Methods In each of two laboratory studies, 20 dogs ≥ 12 months of age were randomly allocated to receive a subcutaneous injection of saline or PH 12 on Day 0 and were then inoculated with 50 D. immitis third-stage larvae (L3) on Day 365. All dogs were necropsied ~ 5 months post-inoculation for adult worm counts. The field efficacy study included dogs ≥ 10 months of age from 19 veterinary clinics in the USA treated with either 20 monthly doses of Heartgard® Plus (HG Plus) (296 dogs) or two doses of PH 12 (297 dogs) on Days 0 and 365. Efficacy was determined on Days 365, 480 and 605 using adult HW antigen and microfilaria testing to assess adult HW infection. Results PH 12 was 100% effective in preventing HW disease in all three of these studies. In the laboratory studies, no PH 12-treated dogs had any adult HWs, whereas all control dogs in both studies had adult HWs [geometric mean, 30.2 (range, 22–37) for Study 1 and 32.6 (22–44) for Study 2]. In the field study, all dogs treated with PH 12 tested negative for adult HW infection on all test days (Days, 365, 480 and 605), whereas four dogs receiving HG Plus (positive control) tested positive for HWs during the study (three dogs on Day 365 and one dog on Day 480). All four dogs treated with HG Plus that subsequently tested positive for HWs during the field study were from the lower Mississippi River Valley region, where HW resistance to macrocyclic lactone preventives has been confirmed to occur. PH 12 was significantly better than HG Plus in preventing heartworm disease in the field study (P = 0.0367). PH 12 was well-tolerated in both laboratory and field studies. Conclusions A single dose of ProHeart® 12 was 100% effective in preventing heartworm disease in dogs for a full year in both laboratory and field studies.
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                Author and article information

                Contributors
                Kennedy Mwacalimba: kennedy.mwacalimba@zoetis.com
                Derek Sears: derek.sears@covetrus.com
                Christopher Brennan: christopher.brennan@zoetis.com
                Barbara Poulsen Nautrup: bpn@EAH-Consulting.de
                Jenifer Sheehy: jenifer.sheehy@zoetis.com
                Kristine Smith: kristine.smith@zoetis.com
                Christopher Adolph: christopher.adolph@zoetis.com
                Journal
                Journal ID (nlm-ta): Parasit Vectors
                Journal ID (iso-abbrev): Parasit Vectors
                Title: Parasites & Vectors
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1756-3305
                Publication date (Electronic): 28 April 2023
                Publication date PMC-release: 28 April 2023
                Publication date Collection: 2023
                Volume: 16
                Electronic Location Identifier: 149
                Affiliations
                [1 ]GRID grid.463103.3, ISNI 0000 0004 1790 2553, Outcomes Research, Zoetis, ; Parsippany, NJ USA
                [2 ]COVETRUS, Portland, ME USA
                [3 ]GRID grid.463103.3, ISNI 0000 0004 1790 2553, Market Research, Zoetis, ; Parsippany, NJ USA
                [4 ]EAH-Consulting, Aachen, Germany
                [5 ]GRID grid.463103.3, ISNI 0000 0004 1790 2553, Veterinary Professional Services, Zoetis, ; Parsippany, NJ USA
                Article
                Publisher ID: 5735
                DOI: 10.1186/s13071-023-05735-y
                PMC ID: 10142219
                PubMed ID: 37106437
                SO-VID: 57dc7c1b-c52c-4f89-9c44-7ecf89b08d8c
                Copyright © © The Author(s) 2023
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 17 December 2022
                Date accepted : 12 March 2023
                Categories
                Subject: Research
                Custom metadata
                issue-copyright-statement © The Author(s) 2023

                ScienceOpen disciplines: Parasitology
                Keywords: heartworm,flea,tick,purchase compliance,retrospective analysis,dog
                Data availability:
                ScienceOpen disciplines: Parasitology
                Keywords: heartworm, flea, tick, purchase compliance, retrospective analysis, dog

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