&lt;p&gt;Impact of Therapy Persistence on Exacerbations and Resource Use in Patients Who Initiated COPD Therapy&lt;/p&gt;

Dalon, Faustine; Devouassoux, Gilles; Belhassen, Manon; Nachbaur, Gaëlle; Silva, Camille Correia Da; Saïl, L.; Jacoud, Flore; Chouaïd, C.; Ganse, Éric Van

doi:10.2147/copd.s222762

Cited by 4 publications

(6 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…∼25% of the initiation or persistence studies (12 out of 49) ( supplementary material, appendix 2 ) cited a rationale for the chosen treatment gap ( e.g. sensitivity analysis [ 51 ], previous research [ 98 , 112 , 128 , 173 ] or duration of a prescription [ 62 , 63 , 81 , 85 , 92 , 119 , 148 ]).…”

Section: Resultsmentioning

confidence: 99%

Methods to assess COPD medications adherence in healthcare databases: a systematic review

Vauterin,

Van Vaerenbergh,

Vanoverschelde

et al. 2023

Eur Respir Rev

View full text Add to dashboard Cite

Background:The Global Initiative for Chronic Obstructive Lung Disease 2023 report recommends medication adherence assessment in COPD as an action item. Healthcare databases provide opportunities for objective assessments; however, multiple methods exist. We aimed to systematically review the literature to describe existing methods to assess adherence in COPD in healthcare databases and to evaluate the reporting of influencing variables.Method:We searched MEDLINE, Web of Science and Embase for peer-reviewed articles evaluating adherence to COPD medication in electronic databases, written in English, published up to 11 October 2022 (PROSPERO identifier CRD42022363449). Two reviewers independently conducted screening for inclusion and performed data extraction. Methods to assess initiation (dispensing of medication after prescribing), implementation (extent of use over a specific time period) and/or persistence (time from initiation to discontinuation) were listed descriptively. Each included study was evaluated for reporting variables with an impact on adherence assessment: inpatient stays, drug substitution, dose switching and early refills.Results:160 studies were included, of which four assessed initiation, 135 implementation and 45 persistence. Overall, one method was used to measure initiation, 43 methods for implementation and seven methods for persistence. Most of the included implementation studies reported medication possession ratio, proportion of days covered and/or an alteration of these methods. Only 11% of the included studies mentioned the potential impact of the evaluated variables.Conclusion:Variations in adherence assessment methods are common. Attention to transparency, reporting of variables with an impact on adherence assessment and rationale for choosing an adherence cut-off or treatment gap is recommended.

show abstract

Section: Resultsmentioning

confidence: 99%

Methods to assess COPD medications adherence in healthcare databases: a systematic review

Vauterin,

Van Vaerenbergh,

Vanoverschelde

et al. 2023

Eur Respir Rev

View full text Add to dashboard Cite

show abstract

“…Patients admitted to hospital for asthma 2 years prior to inclusion for that specific year and over the studied year were excluded. These definitions were based on previous literature 10–13. In the UK, patients with COPD were required to be current/ex-smokers and have a COPD diagnosis code (not available in France) based on previous validation of the identification of patients with COPD in CPRD GOLD 14.…”

Section: Methodsmentioning

confidence: 99%

“…These definitions were based on previous literature. [10][11][12][13] In the UK, patients with COPD were required to be current/ex-smokers and have a COPD diagnosis code (not available in France) based on previous validation of the identification of patients with COPD in CPRD GOLD. 14 Patients in the UK were also required to be eligible for secondary care linkage on the years where they were selected for the cross-sectional study and to have a 'last data collection date' (if patients transferred out of the general practice or died) on or after the year of study.…”

Section: Inclusion Of Patients With Copdmentioning

confidence: 99%

Differences in severe exacerbations rates and healthcare utilisation in COPD populations in the UK and France

Whittaker

Ganse

Dalon³

et al. 2022

BMJ Open Resp Res

Self Cite

View full text Add to dashboard Cite

IntroductionChronic obstructive pulmonary disease (COPD) is a leading cause of mortality in Europe; however, it is important to understand how clinical practice patterns differ between countries and how this might relate to disease outcomes, to identify ways of improving local disease management. We aimed to describe and compare the management of patients with COPD in the UK and France between 2008 and 2017.MethodsWe used data from the Clinical Practice Research Datalink GOLD and Hospital Episode Statistics in the UK and the Echantillon Généraliste des Bénéficiaire in France to identify patients with COPD each year between 2008 and 2017. We compared patient characteristics, all-cause mortality and COPD exacerbations each year between 2008 and 2017 for patients in the UK and France separately. Health care utilisation and COPD exacerbations in 2017 were compared between France and the UK using t-tests and χ2 tests.ResultsPatients with COPD were similar in gender and comorbidities in both countries. Incidence of COPD exacerbations remained stable in the UK and France between 2007 and 2017. In 2017, the proportion of all-cause and COPD-related hospitalisations was greater in the UK than in France (43.9% vs 32.8% and 8.3% vs 4.9%, respectively; p<0.001) as was the proportion of patients visiting accident and emergency (A&E) (39.8% vs 16.2%, respectively; p<0.001). In addition, the mean length of stay in hospital for COPD-related causes was shorter in the UK than in France (6.2 days (SD 8.4) vs 10.5 days (SD 9.1), respectively; p<0.001).DiscussionOverall, UK patients were more likely to go to A&E, be hospitalised for COPD-related causes and stay in hospital for fewer days after being admitted for COPD-related reasons compared with patients in France, illustrating a difference in health-seeking behaviours and access to healthcare.

show abstract

“…A recent French observational study reported that among patients with COPD who persisted with a new therapy for 12 months, 61.2% experienced an exacerbation (compared with 48.1% in our analysis). 18 Symptom burden and direct healthcare costs have also been previously assessed in UK patients who started long-acting bronchodilator therapy. Overall, 40-50% of patients continued to experience breathlessness during the 24-month follow-up period, including among treatment-adherent patients.…”

Section: Healthcare Utilizationmentioning

confidence: 99%

Disease Burden and Healthcare Utilization Among Patients with Chronic Obstructive Pulmonary Disease (COPD) in England

Sansbury¹,

Lipson²,

Bains³

et al. 2022

COPD

View full text Add to dashboard Cite

Clinical guidelines for COPD management suggest pharmacologic treatment algorithms based on symptoms and exacerbation history. As previous research has suggested that prescribing patterns are not always aligned with these recommendations, this study investigated the burden of disease in patients with COPD receiving, and persisting on, new inhaled maintenance therapy. Patients and Methods: This was a retrospective observational study using two linked electronic databases containing health records of patients in England. Patients aged ≥35 years with a confirmed diagnosis of COPD, and who initiated a new inhaled respiratory pharmacologic maintenance regimen between January 1, 2014 and December 31, 2016 (index date) were eligible for inclusion. New treatments could be long-acting muscarinic antagonist (LAMA) or long-acting β 2 -agonist (LABA) monotherapy, inhaled corticosteroid (ICS)/LABA or LAMA/LABA dual therapy, or a multiple-inhaler triple therapy (MITT; LAMA/LABA/ICS). Patients were required to have 12 months of available medical history prior to, and after, the index date. Results: In total, 25,350 eligible patients were identified, of these 8282 (mean age: 70.9 years; 51.5% male) persisted with their newly prescribed inhaled therapy for ≥12 months and were included in the analysis. In the 12 months prior to index, 54% of patients had moderate or severe dyspnea (Medical Research Council score ≥3). The most common therapy initiated at index was MITT (42%), followed by ICS/LABA dual therapy (31.2%). The proportion of patients with moderate or severe dyspnea in the post-index period ranged from 29.0% of patients receiving ICS to 64.2% of patients receiving MITT. In the post-index period, 48.1% of patients experienced ≥1 exacerbation and 54.9% had ≥5 general practitioner visits. Conclusion: Many of the patients with COPD in our study continued to experience symptoms and exacerbations, despite persisting on the same treatment for ≥12 months. This suggests that some patients may benefit from treatment modification in accordance with guideline recommendations.

show abstract

<p>Impact of Therapy Persistence on Exacerbations and Resource Use in Patients Who Initiated COPD Therapy</p>

Cited by 4 publications

References 32 publications

Methods to assess COPD medications adherence in healthcare databases: a systematic review

Methods to assess COPD medications adherence in healthcare databases: a systematic review

Differences in severe exacerbations rates and healthcare utilisation in COPD populations in the UK and France

Disease Burden and Healthcare Utilization Among Patients with Chronic Obstructive Pulmonary Disease (COPD) in England

Contact Info

Product

Resources

About