Medication persistence among patients with asthma/COPD drugs

Haupt, Dan; Krigsman, Kristin; Nilsson, J. Lars G.

doi:10.1007/s11096-008-9197-4

Cited by 47 publications

(41 citation statements)

References 24 publications

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“…A number of studies have explored the prescribing of antiasthmatic drugs in Sweden [8][9][10][11]. Some studies have focused on equity, safety, and regional variation [12][13][14], but most are old studies that included only small populations, did not focus on asthma, dealt with children only, and/or were concerned with acute rather than chronic care.…”

Section: Introductionmentioning

confidence: 99%

Regional variation and adherence to guidelines for drug treatment of asthma

Arnlind¹,

Wettermark²,

Nokela³

et al. 2009

Eur J Clin Pharmacol

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Aims To describe the utilization of antiasthmatic drugs in Sweden and to explore regional variations in drug utilization and adherence to guidelines for rational drug prescribing of antiasthmatics and their rationale. Methods Data on antiasthmatic drugs dispensed between July 2005 and December 2008 to all Swedish citizens aged between 18 and 44 years were obtained from the Swedish National Prescribed Drug Register. The period prevalence was determined by analyzing the number of users/1000 inhabitants, and the incidence by analyzing the number of new users after an 18-month drug-free wash-out period. Three drug-related indicators were used to assess the adherence to guidelines. All measures were analyzed by gender and region. Results A total of 161,000 patients were dispensed antiasthmatics in 2007, corresponding to a prevalence of 4 and 6% among men and women, respectively; the incidence rates were 2 and 3%, respectively. The total drug utilization and adherence to guidelines varied between regions. The total drug expenditures of antiastmatics were 258 million SEK (28 million euro), with fixed dose combinations accounting for 46% of the expenditure. No relation was found between models for allocating prescribing budgets or clear Drug and Therapeutics Committee recommendations and adherence to guidelines. Conclusion There are large regional variations in the utilization of antiasthmatics between Swedish regions, with substantial room for improvement in the adherence to guidelines. New methods of influencing physician behavior may be needed in the future to enhance adherence.

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Section: Introductionmentioning

confidence: 99%

Regional variation and adherence to guidelines for drug treatment of asthma

Arnlind¹,

Wettermark²,

Nokela³

et al. 2009

Eur J Clin Pharmacol

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“…The cost of nonadherence by patients with chronic diseases is estimated to be $300 billion/y in the United States. 12 According to previous research, the adherence rate of subjects with COPD is Ͼ 50% [13][14][15][16][17][18] as opposed to 30 -70% in subjects with asthma. 19 Patient adherence tends to be lower in the evening and declines over time.…”

Section: Problems With Patient Education and Adherence To Aerosol Thementioning

confidence: 99%

“…19 Patient adherence tends to be lower in the evening and declines over time. 14,[20][21][22] Jónasson et al 23 determined the mean adherence rates of 122 children 7 to 16 y of age over a 27-month period using an electronic device monitor. Their findings showed that the mean adherence rate at 3 months was 76.7% compared with 44% by end of the study.…”

Section: Problems With Patient Education and Adherence To Aerosol Thementioning

confidence: 99%

“…Use patterns of prescribed inhaled medications tend to be sporadic. In a 5-y study, Haupt et al 14 revealed that 51% of subjects with obstructive lung diseases acquired their prescribed medications less than once/y. Jung et al 22 studied adherence to prescribed medications in 11,376 subjects with COPD who were Ն60 y of age and reported that 52% used some of their prescribed medications and that only 28% had satisfactory refill patterns of their inhaled corticosteroids.…”

Section: Problems With Patient Education and Adherence To Aerosol Thementioning

confidence: 99%

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Patient Education and Adherence to Aerosol Therapy

Ari

2015

Respir Care

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SummaryNonadherence to prescribed medications results in disease instability and poor clinical control, with increases in hospital admissions, emergency room visits, school/work absenteeism, morbidity, and mortality. Poor patient adherence to therapy can be due to lack of cognition, competence, or contrivance. Patients who have not been trained or fail to understand use of drug and device combinations (cognition) often do not have the ability to use an aerosol device correctly (competence). Many patients have the competence to use the device correctly and know why they should RESPIRATORY CARE • JUNE 2015 VOL 60 NO 6 941 use the device in the way they were taught; however, they still contrive to use it in an ineffective and suboptimal manner that reduces its efficiency and effectiveness. Ensuring effective aerosol therapy and optimizing its role in disease management involve not only delivery of aerosolized medications to the lungs, but also understanding why, when, and how to use the medications, competence to use the device, motivation to adhere to therapy, and not contriving to use the device in a way that will prevent effective drug delivery. This paper explains some of the problems with patient education and adherence to aerosol therapy and suggests strategies to evaluate, monitor, and improve patient adherence effectively in primary care. Factors affecting patient adherence to prescribed medications, effective educational interventions, and strategies to promote patient adherence to aerosol therapy are also discussed.

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“…Less than perfect adherence to ICS appears to account for the majority of asthma-related hospitalizations (4,5). The reported adherence rate of COPD and asthma patients is about 50% and 30-70%, respectively (6)(7)(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Factors affecting satisfaction with education program for chronic airway disease in primary care settings

et al. 2017

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Background: A well-organized education program improved the patients' knowledge about their disease, inhaler technique and quality of life in asthma and chronic obstructive pulmonary disease (COPD) patients.The effectiveness of the education program can be evaluated by assessing patients' satisfaction with the education program as well. In this study, we compared the patients' satisfaction with education program between COPD and asthma patients.Methods: A total of 284 asthma and COPD patients were enrolled. Three educational visits were conducted at 2-week intervals. On the first visit, we taught the patients about their diseases and the proper inhaler technique. On the second visit, non-pharmacologic treatments and action plans for acute exacerbation were introduced. On the final appointment, we summarized the educational concepts covered in the two prior visits. After the education program, the patients were assessed for their quality of life, knowledge of chronic airways disease, and satisfaction with the education program, using a structured questionnaire.Results: After the education program, 99.3% of the asthma patients knew much more about their disease and 96.8% agreed that education from the hospital is needed. For COPD patients, 94.8% felt more informed about their disease and 95.7% agreed that education from the hospital is needed. However, 17.1% of asthma patients and 13.5% of COPD patients disagreed to paying an additional fee for the education program.Finally, the knowledge improvement was linked to patient satisfaction with the education program. Conclusions:The improvement in self-knowledge about their disease was linked to their satisfaction with the education program. However, costs associated with the program could limit its accessibility to the patients. The patient education program is a self-management intervention to improve the lives of patients with asthma and COPD. Thus, a policy to reduce the economic burden of the patients should be considered to disseminate the education program in primary care clinics.

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Medication persistence among patients with asthma/COPD drugs

Abstract: The majority of the patients, and particularly those in the youngest age group used asthma/COPD drugs only sporadically. This may indicate undermedication which is likely to have a negative impact on patient outcome.

Cited by 47 publications

References 24 publications

Regional variation and adherence to guidelines for drug treatment of asthma

Regional variation and adherence to guidelines for drug treatment of asthma

Patient Education and Adherence to Aerosol Therapy

Factors affecting satisfaction with education program for chronic airway disease in primary care settings

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