Adherence to Prescribed Treatment for Asthma: Evidence from Pharmacy Benefits Data

Jones, Craig; Santanello, Nancy C.; Boccuzzi, Steve J; Wogen, Jenifer; Strub, Peg; Nelsen, Linda

doi:10.1081/jas-120017212

Cited by 124 publications

(73 citation statements)

References 18 publications

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“…This observation concurred with the findings of other studies, which indicated that adherence was poor for inhaled medications, both in general and in comparison with oral medications. [28][29][30] As is true for other therapeutic areas (ie, hyperlipidemia, hypertension), medication adherence has been crucial to obtaining the beneficial effects of asthma treatment, and poor adherence to medication has been associated with detrimental health outcomes for patients with asthma. 31,32 In this study, for patients who were adherent (MPR ≥0.8) to their controller medication regimen, the risk of INP/ED visits was lower for patients receiving ICS monotherapy than for those receiving LM.…”

Section: Discussionmentioning

confidence: 99%

Impact of Asthma Controller Medications on Clinical, Economic, and Patient-Reported Outcomes

Tan

Sarawate

Singer

et al. 2009

Mayo Clinic Proceedings

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OBJECTIVE:To comprehensively evaluate clinical, economic, and patient-reported outcomes associated with various therapeutic classes of asthma controller medications. PATIENTS AND METHODS:This observational study, which used administrative claims data from US commercial health plans, included patients with asthma aged 18 through 64 years who filled a prescription for at least 1 asthma controller medication from September 1, 2003, through August 31, 2005. Outcome metrics included the use of short-acting b-agonists (SABAs), the use of oral corticosteroids, inpatient (INP)/emergency department (ED) visits, and asthma-related health care costs. A subset of 5000 patients was randomly selected for a survey using the Mini-Asthma Quality of Life Questionnaire, the Work Productivity and Activity Impairment questionnaire, and the Asthma Therapy Assessment Questionnaire.RESULTS: Of 56,168 eligible patients, 823 returned completed questionnaires. Compared with inhaled corticosteroids (ICSs), leukotriene modifiers (LMs) were associated with lower odds of INP/ED visits (odds ratio [OR], 0.80; P<.001), lower odds of using 6 or more SABA canisters (OR, 0.81; P<.001), and higher annual cost ($193; P<.001). In the subgroup analysis of adherent patients, LMs were associated with higher odds of INP/ED visits (OR, 1.74; P=.04), lower odds of using 6 or more SABA canisters (OR, 0.46; P<.001), and higher annual cost ($235; P<.001). Inhaled corticosteroids and LMs had a comparable impact on all patient-reported outcomes. For combination therapy, ICS plus a long-acting b-agonist consistently showed at least equivalent or better outcomes in the use of SABAs and oral corticosteroids, the risk of INP/ED visits, cost, asthma control level, quality of life, and impairment in productivity and activity.CONCLUSION: Inhaled corticosteroids were associated with a lower risk of INP/ED visits, and a lower cost if adherence was achieved. When adherence cannot be achieved, LMs may be a reasonable alternative. Combination therapy with ICS plus a longacting b-agonist was associated with better or equivalent clinical, economic, and patient-reported outcomes.

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Section: Discussionmentioning

confidence: 99%

Impact of Asthma Controller Medications on Clinical, Economic, and Patient-Reported Outcomes

Tan

Sarawate

Singer

et al. 2009

Mayo Clinic Proceedings

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“…This percentage shows that still many asthmatic patients are not adherent to their inhalational medications. Previously done research shows that, adherence to inhaled therapies is worse than that seen with oral or injected therapies in patients with asthma in different age groups [18][19][20][21]. According to study conducted in turkey to assess the effects of training on the correct use of inhalation devices, only 55.3% of patients were able to correctly use the devices before training but after the training, the rate of correct use increased to 83.7% [22].…”

Section: Discussionmentioning

confidence: 99%

Non Adherence to Inhalational Medications and Associated Factors Among Patients with Asthma in A Referral Hospital in Ethiopia, Using Validated Tool Tai

Ayele

Tegegn

2017

Value in Health

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Background: Asthma is a chronic inflammatory condition of the airways that affects roughly 358 million people globally. It is a serious global health problem with an increasing prevalence worldwide. Most people affected are in low-and middle-income countries including Ethiopia. The association between non -adherence and poor disease control is clearly stated in different literatures. The main objective of the present study was to assess self-reported non-adherence level and to identify the potential factors associated with non-adherence. Methods: An institution based cross-sectional study was conducted in university of Gondar teaching and referral hospital. The data was collected using a validated tool called Test of Adherence to Inhalers (TAI). Result: Among the total of study participants, higher proportions of patients were female (57.3%). Large number of the respondents (59.1%) were Unable to read and write. 18.3% of inhalational user asthmatic patients were not adherent to inhalational medications. According to this study only 49.4% of the respondents were adherent to inhalations and 32. 3% of them were intermediate adherent to inhalational anti asthmatics medications. Lack of education about the Proper use of inhalational anti-asthmatics medications, poly pharmacy and co-morbidities were statistically significant factors associated with non-adherence. Conclusion: The rate of non-adherence to inhalational anti asthmatics is high. Therefore, promoting optimal medication adherences through education, proper patient consultation is essential to optimize the benefits of treatment. Measurement of the degree of non-adherence to inhaled treatment in each individual patient is important in early interventional practice.

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“…[56][57] Such trials do not address the practical issues that impact on effectiveness in real-life primary care practice such as inadequate inhalation technique, 58 perceived side effects of steroids, 59 patient preference for regular treatment, and the impact of adherence. 60 …”

Section: S5mentioning

confidence: 99%

The International Primary Care Respiratory Group (IPCRG) Research Needs Statement 2010

Pinnock

Thomas

Tsiligianni

et al. 2010

Primary Care Respiratory Journal

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Adherence to Prescribed Treatment for Asthma: Evidence from Pharmacy Benefits Data

Cited by 124 publications

References 18 publications

Impact of Asthma Controller Medications on Clinical, Economic, and Patient-Reported Outcomes

Impact of Asthma Controller Medications on Clinical, Economic, and Patient-Reported Outcomes

Non Adherence to Inhalational Medications and Associated Factors Among Patients with Asthma in A Referral Hospital in Ethiopia, Using Validated Tool Tai

The International Primary Care Respiratory Group (IPCRG) Research Needs Statement 2010

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