Medication compliance and disease exacerbation in patients with asthma: a retrospective study of managed care data

Stern, Lee; Berman, Jeff; Lumry, William R.; Katz, Laura M.; Wang, Lujing; Rosenblatt, Lisa; Doyle, John

doi:10.1016/s1081-1206(10)60808-3

Cited by 83 publications

(71 citation statements)

References 14 publications

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“…Briefly, all 23 studies were published between 1993 and 2013. The sample sizes ranged from 24 to 97 743 individuals [9,33]. Two studies were multicentre, seven were single-centre and 14 were based on healthcare (pharmacy/insurance/claim) databases.…”

Section: Overview Of the Included Studiesmentioning

confidence: 99%

“…The four adult studies of good quality (q=8), reporting MPRs [28,29,32,33] concluded that 25% increased adherence was associated with approximately 10% reduction in severe exacerbations (adjusted hazard ratio 0.89 [28], relative rate 0.75 [29], adjusted odds ratios 0.90 [32] and 0.86 33). Similar associations were reported by MATTKE et al [31] (q=8) for leukotriene receptor antagonist users but not for ICS users.…”

Section: Objective Adherence Measurementsmentioning

confidence: 99%

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Medication adherence and the risk of severe asthma exacerbations: a systematic review

et al. 2014

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The benefits of drug therapy for asthma have been well established, but adherence to treatment is poor, and this might be associated with an increased risk of asthma exacerbations. The aim of this study was to review the literature on the association between adherence to asthma controller treatment and risk of severe asthma exacerbations in children and adults.A systematic literature search was performed in PubMed, Embase and Web of Science, from inception until January 2014. Studies were included if data on the association between medication adherence and severe asthma exacerbations were presented. Quality was assessed using a modified version of the Newcastle-Ottawa Scale.The search yielded 2319 unique publications, of which 23 met the inclusion criteria and underwent data extraction and quality scoring. High levels of heterogeneity across studies with regard to adherence and exacerbation measurements, designs and analysis precluded a formal meta-analysis. Although effect measures varied widely, good adherence was associated with fewer severe asthma exacerbations in highquality studies.Good adherence tended to be associated with lower risk of severe asthma exacerbations. Future studies should use standardised methodology to assess adherence and exacerbations, and should consider inhaler competence.@ERSpublications High-quality studies indicated that better adherence is associated with fewer severe asthma exacerbations

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Section: Overview Of the Included Studiesmentioning

confidence: 99%

Section: Objective Adherence Measurementsmentioning

confidence: 99%

Medication adherence and the risk of severe asthma exacerbations: a systematic review

et al. 2014

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“…A recent systematic review showed that good adherence to asthma medication is associated with low risk of severe exacerbation 5 . On the contrary, it has been demonstrated that low rate of adherence to asthma controller therapy is a risk factor for admission to the hospital, near-fatal asthma exacerbations, and death from asthma 6,7 . Furthermore, adherence is also associated with direct and indirect costs of care 8 and quality of life of asthma patients 9 .…”

Section: Corresponding Authormentioning

confidence: 99%

Evaluation of factors affecting adherence to asthma controller therapy in chest clinics in a sub-Saharan African setting: a cross-sectional study

et al. 2016

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Abstract:Background: Adherence to controller therapy in asthma is a major concern during the management of the disease. Objective: To determine the adherence rate and identify the predictors of low adherence to asthma controller therapy. Methods: A cross-sectional study including asthma patients was conducted from November 1, 2012 to May 31, 2013 in 4 chest clinics in Cameroon. The adherence to asthma treatment was rated using Morisky Medication Adherence Scale. A multivariate logistic regression analysis was performed for the identification of factors associated with adherence to asthma treatment. Results: Among the 201 asthma patients included, 133 (66.2%) were female. The mean age of participants was 41.2 years. Sixty-one (30.3%) of the patients did not visit the chest physician during the last year prior to the study. Asthma was well controlled in 118 patients (58.7%). The prevalence of low adherence rate to asthma controller therapy was 44.8% and the absence of any chest specialist visit within the last 12 months was the only factor associated with the low adherence rate to asthma treatment (OR 5.57 ; 95% CI 2.84-10.93). Conclusion:The adherence rate to asthma controller therapy in Cameroon is low and it could be improved if scheduled visits are respected by patients.

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“…Underuse of controller medications may be due to provider underdiagnosis or undertreatment of asthma, or patient medication nonadherence (9). Poor adherence to ICSs has been estimated to account for up to 60% of asthma-related hospitalizations (10)(11)(12)(13)(14). Furthermore, it has been suggested that optimal asthma control entails adherence rates to medication treatment more than 75% of the time (15).…”

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confidence: 99%

Primary Adherence to Controller Medications for Asthma Is Poor

Butler

et al. 2015

Annals ATS

105

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Rationale: Few previous studies have evaluated primary adherence (whether a new prescription is filled within 30 d) to controller medications in individuals with persistent asthma.Objective: To compare adherence to the major controller medication regimens for asthma.Methods: This was a retrospective cohort study of enrollees from five large health plans. We used electronic medical data on patients of all ages with asthma who had experienced an asthma-related exacerbation in the prior 12 months. We studied adherence measures including proportion of days covered and primary adherence (first prescription filled within 30 d).Measurements and Main Results: Our population included 69,652 subjects who had probable persistent asthma and were prescribed inhaled corticosteroids (ICSs), leukotriene antagonists (LTRAs), or ICS/long-acting b-agonists (ICS/LABAs). The mean age was 37 years and 58% were female. We found that 14-20% of subjects who were prescribed controller medicines for the first time did not fill their prescriptions. The mean proportion of days covered was 19% for ICS, 30% for LTRA, and 25% for ICS/LABA over 12 months. Using multivariate logistic regression, subjects prescribed LTRA were less likely to be primary adherent than subjects prescribed ICS (odds ratio, 0.82; 95% confidence interval, 0.74-0.92) or ICS/LABA (odds ratio, 0.88; 95% confidence interval, 0.80-0.97). Black and Latino patients were less likely to fill the prescription compared with white patients.Conclusions: Adherence to controller medications for asthma is poor. In this insured population, primary adherence to ICSs was better than to LTRAs and ICS/LABAs. Adherence as measured by proportion of days covered was better for LTRAs and ICS/LABAs than for ICSs.

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Medication compliance and disease exacerbation in patients with asthma: a retrospective study of managed care data

Cited by 83 publications

References 14 publications

Medication adherence and the risk of severe asthma exacerbations: a systematic review

Medication adherence and the risk of severe asthma exacerbations: a systematic review

Evaluation of factors affecting adherence to asthma controller therapy in chest clinics in a sub-Saharan African setting: a cross-sectional study

Primary Adherence to Controller Medications for Asthma Is Poor

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