A comparison of medication adherence/persistence for asthma and chronic obstructive pulmonary disease in the United Kingdom
Summary Aim To describe and compare adherence and persistence with maintenance therapies in patients with asthma or chronic obstructive pulmonary disease (COPD) in the United Kingdom (UK). Methods A retrospective prescribing database cohort was obtained from 44 general practitioner surgeries in Nati...
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Published in | International journal of clinical practice (Esher) Vol. 68; no. 10; pp. 1200 - 1208 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
England
Blackwell Publishing Ltd
01.10.2014
Hindawi Limited |
Subjects | |
Online Access | Get full text |
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Summary: | Summary
Aim
To describe and compare adherence and persistence with maintenance therapies in patients with asthma or chronic obstructive pulmonary disease (COPD) in the United Kingdom (UK).
Methods
A retrospective prescribing database cohort was obtained from 44 general practitioner surgeries in National Health Service Forth Valley Scotland. Patients with physician‐diagnosed asthma or COPD who received maintenance therapy between January 2008 and December 2009 were included. Five classes of therapy were assessed: inhaled corticosteroids, long‐acting beta‐agonists, combination therapy inhalers, theophyllines and long‐acting muscarinic antagonists. Adherence was calculated using the medication possession ratio (MPR) and persistence was determined using Kaplan–Meier survival analysis for the time to discontinuation (TTD) over 1 year. Two step‐wise logistic regressions were performed to assess the contribution of diagnosis to adherence/persistence.
Results
A total of 13,322 patients were included in the analysis: 10,521 patients with asthma and 2801 patients with COPD. 25.2% of medication episodes for asthma and 45.6% of medication episodes for COPD were classified as having an adequate medication supply (MPR of 80–120%). The overall median TTD was 92 days (IQR, interquartile range: 50–186 days) for patients with asthma and 116 days (IQR: 58–259 days, comparison p < 0.001) for patients with COPD. Patients with COPD were found to be more likely to achieve an MPR of at least 80% (OR: 1.27, 95% CI: 1.15–1.40), but had a similar likelihood of persistence at 1 year to patients with asthma.
Conclusion
Adherence and persistence with respiratory therapies in the UK is relatively low. There is suggestion that patients with COPD may display more adherent behaviours than patients with asthma. |
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Bibliography: | University of Strathclyde ark:/67375/WNG-3ZG2BZ7H-D istex:0D910E20BA6DF7DB097B5582FD414305A517C262 US-UK Fulbright Commission ArticleID:IJCP12451 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1368-5031 1742-1241 |
DOI: | 10.1111/ijcp.12451 |