BACKGROUND: Compliance with asthma medications probably results in improved outcomes, but few studies have examined this relationship. OBJECTIVE: To examine the association between medication compliance and exacerbation in asthmatic patients. METHODS: Retrospective analysis of a managed care database. The 97,743 participants (aged 6-99 years; mean age, 32.8 years) had asthma and prescriptions for controller medications. Compliance with the index medication (the first controller medication prescribed) was measured using 2 methods: medication possession ratio (MPR), calculated for 365 days after the index date, and number of prescriptions for each index medication. Exacerbation was defined as 1 or more emergency department visits or hospitalizations within 1 year of the index date. Multivariate models were used to determine the odds of exacerbation based on relative compliance for each definition of compliance. RESULTS: Based on the median MPR, more-compliant patients were less likely to experience exacerbation than less-compliant patients (odds ratio, 0.94; 95% confidence interval, 0.91-0.97; P < .001). Using the 75th percentile MPR, risk of exacerbation was even smaller (odds ratio, 0.89; 95% confidence interval, 0.86-0.92; P < .001). All the cutoff points for compliance (> or = 2 through > or = 6 prescriptions) demonstrated significantly less exacerbations in more-compliant vs less-compliant patients after adjusting for covariates. As the criteria for compliance became more stringent, more-compliant patients became increasingly less likely to have an exacerbation vs less-compliant patients. CONCLUSION: More-compliant asthmatic patients were significantly less likely to experience exacerbation than less-compliant asthmatic patients. These findings demonstrate the importance of improving medication compliance among asthmatic patients to impact outcomes.
BACKGROUND: Compliance with asthma medications probably results in improved outcomes, but few studies have examined this relationship. OBJECTIVE: To examine the association between medication compliance and exacerbation in asthmatic patients. METHODS: Retrospective analysis of a managed care database. The 97,743 participants (aged 6-99 years; mean age, 32.8 years) had asthma and prescriptions for controller medications. Compliance with the index medication (the first controller medication prescribed) was measured using 2 methods: medication possession ratio (MPR), calculated for 365 days after the index date, and number of prescriptions for each index medication. Exacerbation was defined as 1 or more emergency department visits or hospitalizations within 1 year of the index date. Multivariate models were used to determine the odds of exacerbation based on relative compliance for each definition of compliance. RESULTS: Based on the median MPR, more-compliant patients were less likely to experience exacerbation than less-compliant patients (odds ratio, 0.94; 95% confidence interval, 0.91-0.97; P < .001). Using the 75th percentile MPR, risk of exacerbation was even smaller (odds ratio, 0.89; 95% confidence interval, 0.86-0.92; P < .001). All the cutoff points for compliance (> or = 2 through > or = 6 prescriptions) demonstrated significantly less exacerbations in more-compliant vs less-compliant patients after adjusting for covariates. As the criteria for compliance became more stringent, more-compliant patients became increasingly less likely to have an exacerbation vs less-compliant patients. CONCLUSION: More-compliant asthmatic patients were significantly less likely to experience exacerbation than less-compliant asthmatic patients. These findings demonstrate the importance of improving medication compliance among asthmatic patients to impact outcomes.
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: Ann Chen Wu; Melissa G Butler; Lingling Li; Vicki Fung; Elyse O Kharbanda; Emma K Larkin; William M Vollmer; Irina Miroshnik; Robert L Davis; Tracy A Lieu; Stephen B Soumerai Journal: Ann Am Thorac Soc Date: 2015-02
Authors: Anastasia Sofianou; Melissa Martynenko; Michael S Wolf; Juan P Wisnivesky; Katherine Krauskopf; Elizabeth A H Wilson; Mita Sanghavi Goel; Howard Leventhal; Ethan A Halm; Alex D Federman Journal: J Gen Intern Med Date: 2012-08-10 Impact factor: 5.128
Authors: Thomas Voshaar; Monica Spinola; Patrick Linnane; Alice Campanini; Daniel Lock; Anthony Lafratta; Mario Scuri; Barbara Ronca; Andrea S Melani Journal: J Aerosol Med Pulm Drug Deliv Date: 2013-12-03 Impact factor: 2.849
Authors: Ann Chen Wu; Lingling Li; Vicki Fung; Elyse O Kharbanda; Emma K Larkin; Melissa G Butler; Alison Galbraith; Irina Miroshnik; Robert L Davis; Kelly Horan; Tracy A Lieu Journal: J Allergy Clin Immunol Pract Date: 2016-05-17