Adherence to Inhaled Medications and its Effect on Healthcare Utilization and Costs Among High-Grade Chronic Obstructive Pulmonary Disease Patients

Kim, Jee-Ae; Lim, Min Kyoung; Kim, Kun-Il; Park, Juhee; Rhee, Chin Kook

doi:10.1007/s40261-017-0612-2

Cited by 33 publications

(34 citation statements)

References 31 publications

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“…Thus, education of the importance of inhalers to GP is essential for increasing inhaler prescription. Education of patients is also important, as adherence rates are low . Educational programmes for patients improve awareness of the importance of inhalers .…”

Section: Low Rate Of Use Of Inhalers and High Rate Of Use Of Oral Medmentioning

confidence: 99%

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Management of COPD in Asia: A position statement of the Asian Pacific Society of Respirology

et al. 2019

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Chronic obstructive pulmonary disease (COPD) is a major disease in Asia. However, how to manage specifically Asian COPD patients has not been proposed. Awareness of COPD is very low and underdiagnosis/undertreatment is common in Asian countries. Low utilization of pulmonary function test and inhalers is also a problem. Moreover, high smoking prevalence and air pollution are barriers to managing Asian patients with COPD. The relatively low body mass index of Asian patients with COPD can increase their risk for experiencing adverse effects from COPD drugs. Physicians should consider the unique features of Asian populations with COPD such as the high prevalence rates of bronchiectasis and tuberculosis‐destroyed lungs, biomass smoke exposure and parasitic infection.

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Section: Low Rate Of Use Of Inhalers and High Rate Of Use Of Oral Medmentioning

confidence: 99%

“…Education of patients is also important, as adherence rates are low. 9 Educational programmes for patients improve awareness of the importance of inhalers. 4 Government-level interventions can also be effective.…”

Section: Low Rate Of Use Of Inhalers and High Rate Of Use Of Oral Medmentioning

confidence: 99%

Management of COPD in Asia: A position statement of the Asian Pacific Society of Respirology

et al. 2019

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“…98 This is in contrast to the significant association the authors found between adherence and lower intensive care unit use and healthcare costs within the same population. 98 Given the acute nature of ED visits, there is evidence that a wide range of clinical, psychological and social factors are associated with ED visits in adults, 99 and studies assessing adherence need to adjust for a range of confounding variables. These confounders can also be time-varying, and only 1 of the studies included in our ED meta-analysis (Figure 3) separated the time period for outcome measurement from the exposure assessment period.…”

Section: Discussionmentioning

confidence: 74%

“…The association between non‐adherence and ED visits is not clear in the literature. In fact, a recent Korean study found that after 2 years of being adherent, high‐grade COPD patients had an increased likelihood of having ED visits in comparison to non‐adherent patients . This is in contrast to the significant association the authors found between adherence and lower intensive care unit use and healthcare costs within the same population .…”

Section: Discussionmentioning

confidence: 78%

“…In fact, a recent Korean study found that after 2 years of being adherent, high‐grade COPD patients had an increased likelihood of having ED visits in comparison to non‐adherent patients . This is in contrast to the significant association the authors found between adherence and lower intensive care unit use and healthcare costs within the same population . Given the acute nature of ED visits, there is evidence that a wide range of clinical, psychological and social factors are associated with ED visits in adults, and studies assessing adherence need to adjust for a range of confounding variables.…”

Section: Discussionmentioning

confidence: 92%

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The association between medication non‐adherence and adverse health outcomes in ageing populations: A systematic review and meta‐analysis

Walsh

Cahir

Tecklenborg

et al. 2019

Brit J Clinical Pharma

152

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Aims The aim of this systematic review and meta‐analysis was to synthesise the evidence relating to medication non‐adherence and its association with health outcomes in people aged ≥50 years. Methods Seven databases were searched up to February 2019 for observational studies that measured medication (non‐)adherence as a predictor of the following health outcomes in adults aged ≥50 years: healthcare utilisation (hospitalisation, emergency department visits, outpatient visits and general practitioner visits), mortality, adverse clinical events and quality of life. Screening and quality assessment using validated criteria were completed by 2 reviewers independently. Random effects models were used to generate pooled estimates of association using adjusted study results. The full methodological approach was published on PROSPERO (ID: CRD42017077264). Results Sixty‐six studies were identified for qualitative synthesis, with 11 of these studies eligible for meta‐analyses. A meta‐analysis including 3 studies measuring medication non‐adherence in adults aged ≥55 years showed a significant association with all‐cause hospitalisation (adjusted odds ratio 1.17, 95% confidence interval [CI] 1.12, 1.21). A meta‐analysis including 2 studies showed that medication non‐adherence was not significantly associated with an emergency department visit (adjusted odds ratio 1.05, 95% CI 0.90, 1.22). Good adherence was associated with a 21% reduction in long‐term mortality risk in comparison to medication non‐adherence (adjusted hazard ratio 0.79, 95% CI 0.63, 0.98). Conclusion Medication non‐adherence may be significantly associated with all‐cause hospitalisation and mortality in older people. Medication adherence should be monitored and addressed in this cohort to minimise hospitalisation, improve clinical outcomes and reduce healthcare costs.

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Association between adherence to antihypertensive medications and health outcomes in middle and older aged community dwelling adults; results from the Irish longitudinal study on ageing

Walsh

Cahir

Bennett

2019

Eur J Clin Pharmacol

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Adherence to Inhaled Medications and its Effect on Healthcare Utilization and Costs Among High-Grade Chronic Obstructive Pulmonary Disease Patients

Abstract: Adherence reduces healthcare utilization and costs, so adherence is not only clinically effective but also economically efficient. However, less than one-quarter of this population remained adherent over the 4-year period, suggesting that strategies are needed to improve adherence.

Cited by 33 publications

References 31 publications

Management of COPD in Asia: A position statement of the Asian Pacific Society of Respirology

Management of COPD in Asia: A position statement of the Asian Pacific Society of Respirology

The association between medication non‐adherence and adverse health outcomes in ageing populations: A systematic review and meta‐analysis

Association between adherence to antihypertensive medications and health outcomes in middle and older aged community dwelling adults; results from the Irish longitudinal study on ageing

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