Correlates of adherence to respiratory drugs in COPD patients

Laforest, Laurent; Denis, F.; Ganse, Éric Van; Ritleng, C.; Saussier, Christel; Passante, N; Devouassoux, Gilles; Chatté, G.; Freymond, N.; Pachéco, Yves

doi:10.4104/pcrj.2010.00004

Cited by 46 publications

(63 citation statements)

References 27 publications

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“…Although a prior study by Qian and colleagues reported adherence of at least 80% in 36% of Medicare beneficiaries with COPD, it did not assess adherence among patients newly diagnosed with COPD and evaluated adherence from firstfilled to last-filled prescription, differences that could account for our lower adherence rate (30). Women were less likely to be adherent to COPD maintenance medications compared with men, which is consistent with two prior studies conducted among individuals with COPD (30,46). Other studies have not reported a significant association between sex and adherence to COPD medications or medications generally (11,20,44,47).…”

Section: Original Researchsupporting

confidence: 76%

Adherence to Maintenance Medications among Older Adults with Chronic Obstructive Pulmonary Disease. The Role of Depression

et al. 2016

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Rationale: Among individuals with chronic obstructive pulmonary disease (COPD), depression is one of the most common yet underrecognized and undertreated comorbidities. Although depression has been associated with reduced adherence to maintenance medications used in other conditions, such as diabetes, little research has assessed the role of depression in COPD medication use and adherence.Objectives: The objective of this study was to assess the impact of depression on COPD maintenance medication adherence among a nationally representative sample of Medicare beneficiaries newly diagnosed with COPD. Methods:We used a 5% random sample of Medicare administrative claims data to identify beneficiaries diagnosed with COPD between 2006 and 2010. We included beneficiaries with 2 years of continuous Medicare Parts A, B, and D coverage and at least two prescription fills for COPD maintenance medications after COPD diagnosis. We searched for prescription fills for inhaled corticosteroids, long-acting b-agonists, and long-acting anticholinergics and calculated adherence starting at the first fill. We modeled adherence to COPD maintenance medications as a function of new episodes of depression, using generalized estimated equations.Measurements and Main Results: Our primary outcome was adherence to COPD maintenance medications, measured as proportion of days covered. The exposure measure was depression. Both COPD and depression were assessed using diagnostic codes in Part A and B data. Covariates included sociodemographics, as well as clinical markers, including comorbidities, COPD severity, and depression severity. Of 31,033 beneficiaries meeting inclusion criteria, 6,227 (20%) were diagnosed with depression after COPD diagnosis. Average monthly adherence to COPD maintenance medications was low, peaking at 57% in the month after first fill and decreasing to 35% within 6 months. In our adjusted regression model, depression was associated with decreased adherence to COPD maintenance medications (odds ratio, 0.93; 95% confidence interval, 0.89-0.98).Conclusions: New episodes of depression decreased adherence to maintenance medications used to manage COPD among older adults. Clinicians who treat older adults with COPD should be aware of the development of depression, especially during the first 6 months after COPD diagnosis, and monitor patients' adherence to prescribed COPD medications to ensure best clinical outcomes.

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Section: Original Researchsupporting

confidence: 76%

Adherence to Maintenance Medications among Older Adults with Chronic Obstructive Pulmonary Disease. The Role of Depression

et al. 2016

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“…10 In addition, we included variables possibly associated with adherence including comorbidity, age, gender, visits to the general practitioner, socioeconomic status, psychosocial variables, as well as the year of cohort entry. [18][19][20][21][22][23][24] Appendix- Table 2 (available online) shows a detailed description of all variables. Since previous adherence has been identified as a dominant predictor of future adherence in COPD, 25 we did a fifth sensitivity analysis that did not include previous adherence among possible explanatory variables in the models in order to investigate possible masking of other variables caused by collinearity.…”

Section: Variables Associated With Adherencementioning

confidence: 99%

Low Use and Adherence to Maintenance Medication in Chronic Obstructive Pulmonary Disease in the General Population

et al. 2014

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OBJECTIVE:We tested the hypothesis that use of and adherence to maintenance medication is low among individuals in the general population who have chronic obstructive pulmonary disease (COPD) , even in cases of severe and very severe COPD. DESIGN AND PARTICIPANTS: We identified 5,812 individuals with COPD from the Copenhagen General Population Study, and classified them according to the Global Initiative for Obstructive Lung Disease (GOLD) airflow limitation grades 1-4. Dispensing of fixed-dose combinations of inhaled corticosteroids with long-acting beta 2 -agonists, long-acting anti-cholinergics, or long-acting beta 2 -agonists was identified in a nationwide registry. Use of medication was defined as medication dispensed during a one-year period , and adherence was calculated from dosages available in one year. KEY RESULTS: Use of fixed-dose combinations of inhaled corticosteroids with long-acting beta 2 -agonists varied from 2 % to 61 % (p<0.001, test for trend), long-acting anti-cholinergics varied from 0.4 % to 36 % (p<0.001), and long-acting beta 2 -agonists varied from 0.3 % to 11 % (p<0.001. Among utilizers of these medications, adherence varied from 29 % to 56 % (p<0.001, test for trend) across GOLD 1-4 for fixed-dose combinations of inhaled corticosteroids with long-acting beta 2 -agonists, from 51 % to 68 % (p=0.11) for long-acting anti-cholinergics, and from 25 to 62 % (p=0.01) for long-acting beta 2 -agonists. CONCLUSIONS: Use of and adherence to maintenance medication for COPD in the general population was associated with the severity of COPD as defined by GOLD, but even in severe and very severe COPD, use and adherence was low.

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“…The easiest way to assess medication adherence within clinical settings is to collect information from the patient themselves through questionnaires or patient diaries (Agh et al, 2011;Dolce et al, 1991;George et al, 2005George et al, , 2006aLaforest et al, 2010). However, it should be mentioned that self-reporting methods may overestimate a patient's drug-taking behaviour (Dompleing et al, 1992;Rand et al, 1992Rand et al, , 1995.…”

Section: Methods Of Measuring Adherencementioning

confidence: 99%

“…Adherence differences between men and women reported in the literature may be caused by psychological factors (Laforest et al, 2010). The prevalence of anxiety and depression are higher in women with COPD, and these psychiatric comorbidities have been independently linked with non-adherence ( Bosley et al, 1995;DiMatteo et al, 2000).…”

Section: Factors Related To the Characteristics Of The Patientmentioning

confidence: 99%

“…According to our evaluations, the dosing frequency of respiratory drugs is one of the most important factors affecting non-adherence in patients with COPD (Agh et al, 2011;WHO, 2003). As a partial result of the daily drug doses, a significant difference has been shown in the adherence rates between the different respiratory drug classes (Apter et al, 1998;Breekveldt-Postma et al, 2007;Laforest et al, 2010). Tiotropium, a once-daily inhaled drug, may enhance adherence compared with other inhaled respiratory medications that are dosed more times daily.…”

Section: Factors Related To the Characteristics Of The Therapymentioning

confidence: 99%

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