Abstract
Chronotherapy involves the administration of medication in coordination with the body’s circadian rhythms to maximise therapeutic effectiveness and minimise/avoid adverse effects. The aim of this study is to investigate the “time of administration” recommendations on chronotherapy for commonly-prescribed medicines in Australia. This study also aimed to explore the quality of information on the timing of administration presented in drug information sources, such as consumer medicine information (CMI) and approved product information (PI). Databases were searched for original research studies reporting on the impact of “time of administration” of the 30 most commonly-prescribed medicines in Australia for 2014. Further, time of administration recommendations from drug information sources were compared to the evidence from chronotherapy trials. Our search revealed 27 research studies, matching the inclusion and exclusion criteria. In 56% (n = 15) of the research studies, the therapeutic effect of the medicine varied with the time of administration, i.e., supported chronotherapy. For some medicines (e.g., simvastatin), circadian-based optimal administration time was evident in the information sources. Overall, dedicated studies on the timing of administration of medicines are sparse, and more studies are required. As it stands, information provision to consumers and health professionals about the optimal “time” to take medications lags behind emerging evidence.
Highlights
The “time” of administration of medication is valuable information to consider during patient counselling and is a typical query by patients especially when filling a prescription for the first time [1].Various therapeutic management support systems and novel technologies have been developed to assist health professionals, including clinical pharmacists, in ensuring the rational and safe use of medicines
Out of the 27 research studies, 56% (n = 15) indicated that the therapeutic effect of the medicine varied with the time of administration of medication, i.e., supported chronotherapy
Supporting chronotherapy for antihypertensives was a randomised crossover study reported by Morgan et al This study demonstrated that the duration of the blood pressure lowering effect of perindopril (4 mg) when administered to 18 hypertensive men was 24 h when given in the morning at 9 a.m., whereas it was only 12–14 h when administered at 9 p.m
Summary
The “time” of administration of medication is valuable information to consider during patient counselling and is a typical query by patients especially when filling a prescription for the first time [1]. Various therapeutic management support systems and novel technologies have been developed to assist health professionals, including clinical pharmacists, in ensuring the rational and safe use of medicines. One such “tool” in the armoury of clinical pharmacists is to exploit the knowledge of biological rhythms in humans. A human biological rhythm with a period of around 24 h is known as circadian rhythm. Circadian rhythms are endogenous in nature and are known to persist under free-running conditions [2,3,4].
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