Does use of a corticosteroid/long-acting beta-agonist combination inhaler increase adherence to inhaled corticosteroids?

Foden, Jay; Hand, Christopher

doi:10.3132/pcrj.2008.00051

Cited by 9 publications

(7 citation statements)

References 3 publications

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“…27,32,38,39 In subjects with asthma, better adherence was observed in those who were using dual therapy (ie, ICS/LABA) than in those using ICS alone, which may be due to the increased benefit of the medicine and better symptom control with combination therapy. 75 This review could not establish any relationship between treatment adherence and subjects initiating therapy because more than half of the included studies did not report the time since therapy was initiated. A limitation among the reviewed articles is that, even though the majority of subjects in half of the studies were using their medication for > 12 months, the data were still inadequate to compare adherence of newly prescribed medicine users with the adherence of prevalent users.…”

Section: Discussionmentioning

confidence: 99%

Barriers and Strategies for Improving Medication Adherence Among People Living With COPD: A Systematic Review

et al. 2020

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BACKGROUND: While medication is an integral component of the effective management of COPD, contemporary studies report that more than half of all people who are prescribed medication for the management of their COPD do not adhere to therapy. Enhancing medication adherence and improving health outcomes for those living with COPD are among the key challenges for the global health community. This systematic review aims to identify the rate of nonadherence among people who are prescribed controller medication for the management of their COPD, and identifies the barriers and facilitators that influence their medication use behavior. METHODS: A systematic search of medical databases (ie, MEDLINE, CINHAL, and EMBASE) was conducted using key words to identify literature in the English language, published between January 2003 and December 2019. Included studies were assessed for quality using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. RESULTS: A total of 1,474 studies were identified from the initial database search, of which 38 met the inclusion criteria. Of these 38 studies, 37 reported on rates of nonadherence (ranging from 22% to 93%), 30 reported on barriers to adherence, 24 reported on enablers to adherence, and 16 reported on both. The majority (33) of the studies were conducted in high-income nations. The quality of articles ranged from 47% to 90%. Medication-taking behavior was reported to be influenced by several factors such as subjects' beliefs about medication, their experiences of and satisfaction with medication effectiveness, their concerns regarding medication side effects, their personal circumstances, habits and health status, and their relationships with health care providers. CONCLUSIONS: Adherence to COPD medication was generally low, with the majority of studies identifying the presence of depression and subjects' concern about the harmful effects of the medicine as barriers to adherence. Variability exists on the reported rates of nonadherence, possibly due to different measures utilized to assess adherence. Future research in low-income nations is needed.

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Section: Discussionmentioning

confidence: 99%

Barriers and Strategies for Improving Medication Adherence Among People Living With COPD: A Systematic Review

et al. 2020

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“…Better adherence has also been observed when patients are treated with combination ICS/long-acting b 2 -agonists (LABA) therapy compared with ICS alone (72.2% versus 40.5%, respectively, p Z 0.001), possibly due to the positive reinforcing effects of improved and more immediate symptom control with combination therapy. 62 More studies are necessary to fully establish the connection between the type of inhaler device and treatment adherence.…”

Section: Inhaler Devices and Adherencementioning

confidence: 99%

Adherence to inhaled therapies, health outcomes and costs in patients with asthma and COPD

Mäkelä

Backer

Hedegaard³

et al. 2013

Respiratory Medicine

415

277

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Suboptimal adherence to pharmacological treatment of asthma and chronic obstructive pulmonary disease (COPD) has adverse effects on disease control and treatment costs. The reasons behind non-adherence revolve around patient knowledge/education, inhaler device convenience and satisfaction, age, adverse effects and medication costs. Age is of particular concern given the increasing prevalence of asthma in the young and increased rates of non-adherence in adolescents compared with children and adults. The correlation between adherence to inhaled pharmacological therapies for asthma and COPD and clinical efficacy is positive, with improved symptom control and lung function shown in most studies of adults, adolescents and children. Satisfaction with inhaler devices is also positively correlated with improved adherence and clinical outcomes, and reduced costs. Reductions in healthcare utilisation are consistently observed with good adherence; however, costs associated with general healthcare and lost productivity tend to be offset only in more adherent patients with severe disease, versus those with milder forms of asthma or COPD. Non-adherence is associated with higher healthcare utilisation and costs, and reductions in health-related quality of life, and remains problematic on an individual, societal and economic level. Further development of measures to improve adherence is needed to fully address these issues.

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“…The concurrent delivery of a bronchodilator (LABA) may provide a symptomatic benefit with use of FDC inhalers that promotes inhaler use, and thus improved adherence with treatment and increased consumption of concomitant ICS. 31,32 Other authors have hypothesized there may be a biochemical synergy between ICS and LABA with their codeposition in the airways. 33,34 Moreover, an important advantage of combining ICS and LABA in one inhaler is the prevention of LABA use as monotherapy, which carries potential increased risk of asthma-related mortality and since 2005 is accompanied by a Food and Drug Administration (FDA) "black box" warning in the US.…”

Section: Primary Outcomementioning

confidence: 99%

Long-Acting β-Agonist in Combination or Separate Inhaler as Step-Up Therapy for Children with Uncontrolled Asthma Receiving Inhaled Corticosteroids

Turner

Richardson²,

Murray

et al. 2017

The Journal of Allergy and Clinical Immunology: In Practice

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Does use of a corticosteroid/long-acting beta-agonist combination inhaler increase adherence to inhaled corticosteroids?

Cited by 9 publications

References 3 publications

Barriers and Strategies for Improving Medication Adherence Among People Living With COPD: A Systematic Review

Barriers and Strategies for Improving Medication Adherence Among People Living With COPD: A Systematic Review

Adherence to inhaled therapies, health outcomes and costs in patients with asthma and COPD

Long-Acting β-Agonist in Combination or Separate Inhaler as Step-Up Therapy for Children with Uncontrolled Asthma Receiving Inhaled Corticosteroids

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