Adherence to asthma controller medication regimens - 17/08/11

Doi : 10.1016/j.rmed.2005.03.002

D.A. Stempel ^a,^⁎ , S.W. Stoloff ^b, J.R. Carranza Rosenzweig ^c, R.H. Stanford ^c, K.L. Ryskina ^d, A.P. Legorreta ^e
^a Department of Pediatrics, Infomed Northwest and University of Washington, Bellevue, WA 98004, USA
^b University of Nevada School of Medicine, Reno, USA
^c GSK, RTP, NC, USA
^d Health Benchmarks, Woodland Hills, CA, USA
^e Department of Health Services, School of Public Health, University of California, Los Angeles, CA, USA

Corresponding author.

Summary

Background

Improved adherence to inhaled corticosteroids (ICS) is recognized as an important factor in reduced morbidity, mortality and consumption of health care resources. The present study was designed to replicate pervious reports of patient adherence with fluticasone/salmeterol in a single inhaler (FSC), fluticasone and salmeterol in separate inhalers (FP+SAL), fluticasone and montelukast (FP+MON), fluticasone alone (FP) and montelukast alone (MON).

Methods

A 24-month observational retrospective study was conducted using administrative claims data. Subjects were ≥12 years old with 24 months of continuous enrollment; had ≥1 asthma claim (ICD-9: 493), ≥1 short-acting beta₂-agonist claim, and ≥1 FSC, FP, SAL, or MON claim. Outcomes included asthma medication refill rates and persistence measured by treatment days. This study was designed with a unique population of patients with asthma from different health plans to validate previous findings.

Results

A total of 3503 subjects were identified based on their index medication: FSC (996), FP+SAL (259), FP+MON (101), FP (1254) and MON (893). Mean number of prescription refills for FSC (3.98) was significantly higher than FP (2.29) and the FP component of FP+SAL (2.36), and FP+MON (2.15), . No significant differences were observed between FSC and MON fill rates (4.33). Mean number of treatment days was greater for FSC compared to FP, FP+SAL, and FP+MON ( ).

Conclusion

This study confirms a previous report that adherence profiles of fluticasone and salmeterol in a single inhaler are significantly better when compared to the controller regimens of fluticasone and salmeterol in separate inhalers, fluticasone and montelukast, or fluticasone alone and similar to montelukast alone.

Le texte complet de cet article est disponible en PDF.

Keywords : Adherence, Asthma, Inhaled corticosteroids, Fluticasone propionate, Salmeterol, Montelukast, Long-acting bronchodilators, Leukotriene receptor antagonists, Adherence, Refill persistence