POSC420 Assessing Algorithms to Identify Asthma Patients Using Multiple Inhaler Triple Therapy (comprising ICS, LABA, LAMA) in a Real-World Database

Meeraus, Wilhelmine; Numbere, B; Liu, Y; Czira, Alexandrosz; Zhang, W

doi:10.1016/j.jval.2021.11.1321

Cited by 1 publication

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“…However, they do not guarantee that the medication was taken exactly as prescribed or on what exact days patients are taking their medications, leading to a risk of misclassifying MITT users and non-users. To mitigate this, the performance of several existing algorithms was tested and assessed in exploratory analyses, to identify a single robust algorithm for the main analyses 7. As there were no external standards or validated algorithms against which to compare, the assessment was subjective, and each metric was recalculated following adaptations to the original, existing algorithms.…”

Section: Discussionmentioning

confidence: 99%

“…To mitigate this, the performance of several existing algorithms was tested and assessed in exploratory analyses, to identify a single robust algorithm for the main analyses. 7 As there were no external standards or validated algorithms against which to compare, the assessment was subjective, and each metric was recalculated following adaptations to the original, existing algorithms. To explore the findings from this study, further observational studies, randomised controlled trials or prospective studies should be conducted using other secondary datasets.…”

Section: Discussionmentioning

confidence: 99%

“…MITT initiation was identified based on overlapping dispensed prescriptions for all three MITT components. The discontinuation of MITT use was identified as a greater than 45-day gap in prescribing MITT components 7. The MITT algorithm was defined as any period of overlap (≥1 day) between ICS/LABA and LAMA dispensed on the same or different days.…”

Section: Methodsmentioning

confidence: 99%

“…The discontinuation of MITT use was identified as a greater than 45-day gap in prescribing MITT Open access components. 7 The MITT algorithm was defined as any period of overlap (≥1 day) between ICS/LABA and LAMA dispensed on the same or different days. The recorded days of supply were used to calculate the prescription duration with no stockpiling or stretch periods applied.…”

Section: Mitt Use and Discontinuationmentioning

confidence: 99%

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Characteristics, treatment patterns and burden of illness in US patients with asthma newly initiating multiple-inhaler triple therapy

Numbere,

Liu,

Zhang

et al. 2024

BMJ Open Resp Res

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IntroductionFor patients with asthma who remain symptomatic on medium-dose inhaled corticosteroid/long-acting β2-agonist, add-on long-acting muscarinic antagonist is a treatment option, which can be administered as multiple-inhaler triple therapy (MITT). A high proportion of patients (61.5%–88.2%) discontinue MITT use within 1 year postinitiation; however, which patients discontinue and their treatment patterns at initiation are unknown. This study aimed to understand the demographic, clinical and treatment-related characteristics of patients with asthma who newly initiated MITT, by discontinuation status.MethodsThis retrospective cohort study used administrative data from IBM Truven MarketScan Commercial Claims and Encounters Database with Medicare supplement between 1 January 2016 and 31 December 2019. Adult patients with asthma who initiated MITT between 1 January 2017 and 31 March 2019 were included and were classified based on their discontinuation status. ‘Continuous users’ had continuous use of MITT and ‘discontinuers’ discontinued treatment within the 6-month period postinitiation. Demographics and clinical characteristics, asthma treatment use prior to MITT initiation (12-month baseline period), mode of MITT initiation and complexity of regimen were described.ResultsOf 4132 patients (mean age: 49.0 years, 67.9% female), 78.0% (n=3224) were discontinuers; 22.0% (n=908) were continuous users. Demographic and other clinical and treatment-related characteristics during baseline were broadly similar between cohorts. A significantly higher proportion of continuous users versus discontinuers had ≥6 dispensed claims for short-acting β2-agonist canisters (16.0% vs 12.5%; p=0.006) during baseline and initiated a once-daily MITT regimen (35.2% vs 26.2%; p<0.001). Fewer continuous MITT users used a mix of once-daily and twice-daily regimens than those who discontinued MITT (64.3% vs 72.3%; p<0.001).ConclusionsMost patients with asthma discontinued MITT within 6 months. Results indicate that patients with a history of uncontrolled, symptomatic asthma and those using less complex triple therapy regimens at initiation are less likely to discontinue MITT than patients with controlled asthma and those using a complex MITT regimen.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Mitt Use and Discontinuationmentioning

confidence: 99%

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