Medication adherence in patients with asthma using once-daily versus twice-daily ICS/LABAs

Averell, Carlyne M; Stanford, Richard H.; Laliberté, François; Wu, Jiao; Germain, Guillaume; Duh, Mei Sheng

doi:10.1080/02770903.2019.1663429

Cited by 36 publications

(40 citation statements)

References 25 publications

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“…Our results are broadly comparable with those of three database studies performed in the USA and Japan [ 21 , 35 , 36 ]. In their retrospective cohort study, Stanford et al .…”

Section: Discussionsupporting

confidence: 90%

“…Our results are broadly comparable with those of three database studies performed in the USA and Japan [21,35,36]. In their retrospective cohort study, Stanford et al found that patients initiating once-daily FF/VI were more likely to be adherent (measured by PDC) and less likely to discontinue treatment than patients initiating twice-daily BUD/FM; however, persistence was low for both treatments [35].…”

Section: Discussionsupporting

confidence: 87%

“…Additionally, two binary outcomes-patients C 50% adherent and patients C 80% adherent-were created and analysed. Taking C 80% of medication as prescribed has been generally considered as acceptable adherence for clinical outcomes, based on findings from a seminal hypertension study [19]; however, as it is now recognised that this cut-off value may vary for different diseases and classes of medication [20], we also analysed a lower adherence cut-point, chosen to allow comparison with previous asthma studies [21][22][23][24][25]. The protocol was approved by local ethics committees.…”

Section: Methodsmentioning

confidence: 99%

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Persistence and Adherence to ICS/LABA Drugs in UK Patients with Asthma: A Retrospective New-User Cohort Study

et al. 2020

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Introduction: Asthma is associated with significant economic burden. Inhaled corticosteroid and long-acting beta 2-agonist (ICS/LABA) combination therapies are considered mainstays of treatment. We describe real-world use of ICS/LABAs by comparing treatment persistence and adherence among patients with asthma in the United Kingdom initiating fluticasone furoate/vilanterol (FF/VI) versus budesonide/ formoterol (BUD/FM) or beclometasone dipropionate/formoterol (BDP/FM). Methods: A retrospective new-user active comparator database study was conducted in the IQVIA Medical Research Database. Propensity score (PS) matching was performed for FF/VI versus BUD/FM, and FF/VI versus BDP/ FM. The primary objective was to compare patient treatment persistence (time to discontinuation), while secondary objectives included assessing adherence (mean proportion of days covered [PDC] with medication in the study period) and the proportions of patients achieving C 50% and C 80% PDC.

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“…Our results are broadly comparable with those of three database studies performed in the USA and Japan [ 21 , 35 , 36 ]. In their retrospective cohort study, Stanford et al .…”

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 87%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Persistence and Adherence to ICS/LABA Drugs in UK Patients with Asthma: A Retrospective New-User Cohort Study

et al. 2020

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“…Also, patients on teriflunomide showed better adherence than patients using DMF, which may be due to difference in dosing scheme (teriflunomide once daily vs. DMF twice daily). In other therapeutic areas, higher dosing frequency has been associated with lower adherence in several, [17][18][19][20] but not in all, 21,22 studies. In addition, persistence to treatment was also higher with oral agents versus injectables.…”

Section: Treatment Persistencementioning

confidence: 99%

Medication adherence/persistence among patients with active multiple sclerosis in Finland

Lahdenperä¹,

Soilu‐Hänninen

Kuusisto

et al. 2020

Acta Neurol Scand

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Poor treatment adherence is associated with increased relapse frequency, greater healthcare resource utilization, increased cost, and poorer patient outcomes than observed in adherent patients. 1-3 Therefore, it is vital to identify the frequency and understand the reasons for non-adherence in patients with multiple sclerosis (MS). From the 1990s to 2011, beta-interferons and glatiramer acetate were standard first-line disease-modifying therapies (DMTs) for

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“…6 Lastly, medication burden may contribute towards poor adherence. 7 In the UK, there has been an increase in the proportion receiving higher level medication (medium or high dose inhaled corticosteroids, ICS). 1 Of those prescribed a medium/high dose combination inhaler as their first ever preventer, 70% remained on the same inhaler for several years.…”

Section: Introductionmentioning

confidence: 99%

<p>Qualitative Study of Practices and Challenges of Stepping Down Asthma Medication in Primary Care Across the UK</p>

Bloom¹,

Ramsey²,

Alter³

et al. 2020

JAA

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Background: Guidelines recommend that asthma treatment should be stepped down to the minimally effective dose that achieves symptom control to prevent medication side effects and reduce unnecessary costs. Little is known about the practice of stepping down and the challenges in primary care, where most asthma patients are managed. Objective: To explore views, experiences, barriers and ideas, of doctors, nurses and pharmacists working in primary care, related to step down of asthma medication. Methods: Primary care practitioners from across the UK participated in a survey and/or semi-structured interview. Questions explored four main areas: how asthma medication is reviewed, views on asthma guidelines, perceived barriers faced by healthcare workers and facilitators of stepping down. Qualitative content analysis enabled data coding of interview transcripts to identify major themes. Results: A total of 274 participants responded to the survey, 29 participated in an interview (12 doctors, 9 nurses, and 8 pharmacists), working in GP practices from across the UK. Nearly half of the survey participants infrequently step down asthma medication (doc-tors=42.7%, nurses=46.3%). Four major themes related to barriers to stepping down were (i) lack of awareness of the need to step down, (ii) inertia to step down, driven by low confidence in ability, fear of consequences, and concern for who is responsible for stepping down, (iii) self-efficacy of ability to step down, influenced by lack of clear, applied guidance and limited training, and (iv) feasibility of step down, driven by a lack of systematic acceptance of stepping down and time. Strategies proposed to reduce overtreatment included education and training, improved gathering of evidence and guidance, and integrating step down into routine asthma care. Conclusion: Failure to implement this guideline recommendation into everyday asthma management is influenced by several contributing factors. Future directions should include addressing evidence gaps, implementing clear and practical guidance, integration of stepdown assessment into the asthma review, and education of professionals and patients.

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Medication adherence in patients with asthma using once-daily versus twice-daily ICS/LABAs

Cited by 36 publications

References 25 publications

Persistence and Adherence to ICS/LABA Drugs in UK Patients with Asthma: A Retrospective New-User Cohort Study

Persistence and Adherence to ICS/LABA Drugs in UK Patients with Asthma: A Retrospective New-User Cohort Study

Medication adherence/persistence among patients with active multiple sclerosis in Finland

<p>Qualitative Study of Practices and Challenges of Stepping Down Asthma Medication in Primary Care Across the UK</p>

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