A comparison of medication adherence/persistence for asthma and chronic obstructive pulmonary disease in the United Kingdom

J. R. Covvey, A. B. Mullen, M. Ryan, D. T. Steinke, B. F. Johnston, F. T. Wood, A. C. Boyter

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

The aim of this article is 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).  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.  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.  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.

LanguageEnglish
Pages1200-1208
Number of pages9
JournalInternational Journal of Clinical Practice
Volume68
Issue number10
Early online date5 May 2014
DOIs
Publication statusPublished - 1 Oct 2014

Fingerprint

Medication Adherence
Chronic Obstructive Pulmonary Disease
Asthma
United Kingdom
Respiratory Therapy
Muscarinic Antagonists
Nebulizers and Vaporizers
Kaplan-Meier Estimate
National Health Programs
Scotland
Therapeutics
Theophylline
Survival Analysis
General Practitioners
Adrenal Cortex Hormones
Logistic Models
Databases
Physicians

Keywords

  • asthma
  • chronic obstructive pulmonary disease
  • medication

Cite this

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abstract = "The aim of this article is 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).  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.  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.  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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A comparison of medication adherence/persistence for asthma and chronic obstructive pulmonary disease in the United Kingdom. / Covvey, J. R.; Mullen, A. B.; Ryan, M.; Steinke, D. T.; Johnston, B. F.; Wood, F. T.; Boyter, A. C.

In: International Journal of Clinical Practice, Vol. 68, No. 10, 01.10.2014, p. 1200-1208.

Research output: Contribution to journalArticle

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