Treatment with inhaled corticosteroids in asthma is too often discontinued

Abstract

New users of both single and fixed combined ICS have alarming low persistence rates with ICS-treatment in the first year of follow-up. Persistence was mainly related to patient factors, such as severity of disease, and to treatment-related factors, such as once-daily dosing frequency.

Asthma inhaler adherence determinants in adults: systematic review of observational data

“…Patients receiving prescriptions from a specialist, using MDIs, having a lower recommended dose, having once-daily dosing frequency, having used LABAs in the previous year, and having had previous asthma-related hospitalisations were more likely to persist using single ICS treatment during 1 year, while adolescents and patients with more than twice daily dosing frequency were more likely to discontinue [56]. For ICS/LABA therapy, persistence was less likely for adults compared to children, for people with longer therapy duration, higher daily dose, and having used antibiotics in the previous year [56].…”

“…For ICS/LABA therapy, persistence was less likely for adults compared to children, for people with longer therapy duration, higher daily dose, and having used antibiotics in the previous year [56]. Patients using ICS/LABA were more likely to persist with therapy compared to those using ICS+LABA, as were male patients, older patients, those receiving social assistance, those with lower daily dosage, those receiving prescriptions from a specialist, and those using more medications currently and in the previous year [50].…”

Inhaler Operability and Patient Satisfaction Regarding Genuair® and Respimat® Inhalers for Chronic Obstructive Pulmonary Disease: A Randomized Crossover Study

“…Inhaled medications containing long-acting muscarinic antagonists (LAMA), long-acting beta 2 agonists (LABA), or a combination of both are used in daily clinical practice world-wide. However, patient adherence to inhalation drugs is generally poorer than to oral medications [3] or combination drugs [4]. Inhalation adherence is a significant factor in the management of COPD.…”

Suboptimal persistence with inhaled corticosteroid monotherapy among children with persistent asthma in the UK

“…In the Netherlands, a large database study found 49% persistence at 100 days and <10% persistence at one year after start of ICS monotherapy among patients aged 35 years and younger; the results were similar when stratified by age. 17 Jones and co-workers 19 reported 25% and 22% persistence with ICS monotherapy at six and nine months, respectively, in their study of pharmacy claims data in the US. In another study in the Netherlands, children were more likely to continue with their asthma medications if they received their first prescription for asthma medication at age 2 or 3 years (versus ≤1 year) or if they received prescriptions for β 2-agonist and ICS (versus just β 2-agonist).…”

“…[9][10][11][12][13][14] Long-term studies indicate that adherence to asthma controller therapy decreases over time, 15,16 and persistence with therapy may be poor. 17,18 'Adherence' to asthma controller therapy can be defined as the proportion of doses taken as prescribed, while 'persistence' with therapy applies to duration of therapy, namely, the continued use of the prescribed medication over time. 18,19 The objective of this observational study was to assess persistence with therapy after a first prescription for ICS monotherapy among children with persistent asthma, as recorded in a large primary care database.…”