BACKGROUND: Pharmacy database medication refill studies provide a panoramic view of medication-taking behavior in patients nationally. OBJECTIVE: To investigate fluticasone propionate/salmeterol combination (FSC) adherence, including the factors associated with refill adherence in a large national pharmacy database. METHODS: Adherence and persistence were documented for 12 months from date of initial FSC prescription in 5504 patients who filled their medication at a nationwide pharmacy chain. RESULTS: On average, patients filled enough medication to cover 22.2% of days. More than half the patients filled a 30-day prescription only once over the 1-year interval. Higher adherence levels were associated with being male, being older than 35 years, having a comorbid disorder, a having a copay of 1.01 dollar to 10 dollars, previous beta2-agonist use, and a prescription for higher-dose FSC. CONCLUSION: This pharmacy database study portrays medication adherence levels to be considerably lower than those reported in most clinical trials, suggests that most adults taking FSC obtain a single fill before abandoning their controller medication, and indicates a need for a reappraisal of current treatment guidelines and educational strategies for both providers and patients. CLINICAL IMPLICATIONS: For many patients, filling of a controller medication is markedly discrepant with practice guidelines. Reappraisal of both the guidelines and strategies to implement them is in order.
BACKGROUND: Pharmacy database medication refill studies provide a panoramic view of medication-taking behavior in patients nationally. OBJECTIVE: To investigate fluticasone propionate/salmeterol combination (FSC) adherence, including the factors associated with refill adherence in a large national pharmacy database. METHODS: Adherence and persistence were documented for 12 months from date of initial FSC prescription in 5504 patients who filled their medication at a nationwide pharmacy chain. RESULTS: On average, patients filled enough medication to cover 22.2% of days. More than half the patients filled a 30-day prescription only once over the 1-year interval. Higher adherence levels were associated with being male, being older than 35 years, having a comorbid disorder, a having a copay of 1.01 dollar to 10 dollars, previous beta2-agonist use, and a prescription for higher-dose FSC. CONCLUSION: This pharmacy database study portrays medication adherence levels to be considerably lower than those reported in most clinical trials, suggests that most adults taking FSC obtain a single fill before abandoning their controller medication, and indicates a need for a reappraisal of current treatment guidelines and educational strategies for both providers and patients. CLINICAL IMPLICATIONS: For many patients, filling of a controller medication is markedly discrepant with practice guidelines. Reappraisal of both the guidelines and strategies to implement them is in order.
Authors: L Keoki Williams; Edward L Peterson; Karen Wells; Brian K Ahmedani; Rajesh Kumar; Esteban G Burchard; Vimal K Chowdhry; David Favro; David E Lanfear; Manel Pladevall Journal: J Allergy Clin Immunol Date: 2011-10-21 Impact factor: 10.793
Authors: Sunil Kripalani; Kathryn Goggins; Sam Nwosu; Jonathan Schildcrout; Amanda S Mixon; Candace McNaughton; Amanda M McDougald Scott; Kenneth A Wallston Journal: J Health Commun Date: 2015
Authors: William M Vollmer; Adrianne Feldstein; David H Smith; Joan P Dubanoski; Amy Waterbury; Jennifer L Schneider; Shelley A Clark; Cynthia Rand Journal: Am J Manag Care Date: 2011-12 Impact factor: 2.229