A comparison of medication adherence/persistence for asthma and chronic obstructive pulmonary disease in the United Kingdom.
Int J Clin Pract
; 68(10): 1200-8, 2014 Oct.
Article
in En
| MEDLINE
| ID: mdl-24797899
ABSTRACT
AIM:
To describe and compare adherence and persistence with maintenance therapies in patients with asthma or chronic obstructive pulmonary disease (COPD) in the United Kingdom (UK).METHODS:
A retrospective prescribing database cohort was obtained from 44 general practitioner surgeries in National Health Service Forth Valley Scotland. Patients with physician-diagnosed asthma or COPD who received maintenance therapy between January 2008 and December 2009 were included. Five classes of therapy were assessed inhaled corticosteroids, long-acting beta-agonists, combination therapy inhalers, theophyllines and long-acting muscarinic antagonists. Adherence was calculated using the medication possession ratio (MPR) and persistence was determined using Kaplan-Meier survival analysis for the time to discontinuation (TTD) over 1 year. Two step-wise logistic regressions were performed to assess the contribution of diagnosis to adherence/persistence.RESULTS:
A total of 13,322 patients were included in theanalysis:
10,521 patients with asthma and 2801 patients with COPD. 25.2% of medication episodes for asthma and 45.6% of medication episodes for COPD were classified as having an adequate medication supply (MPR of 80-120%). The overall median TTD was 92 days (IQR, interquartile range 50-186 days) for patients with asthma and 116 days (IQR 58-259 days, comparison p < 0.001) for patients with COPD. Patients with COPD were found to be more likely to achieve an MPR of at least 80% (OR 1.27, 95% CI 1.15-1.40), but had a similar likelihood of persistence at 1 year to patients with asthma.CONCLUSION:
Adherence and persistence with respiratory therapies in the UK is relatively low. There is suggestion that patients with COPD may display more adherent behaviours than patients with asthma.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Asthma
/
Pulmonary Disease, Chronic Obstructive
/
Medication Adherence
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
Int J Clin Pract
Journal subject:
MEDICINA
Year:
2014
Document type:
Article
Affiliation country:
Reino Unido