A Sicras-Mainar1, A Huerta2, D Sánchez3, R Navarro-Artieda4. 1. Dirección de Planificación, Badalona Serveis Assistencials, Badalona, Barcelona, España. 2. Departamento de Evaluación de Medicamentos, GlaxoSmithKline, Madrid, España. Electronic address: alicia.h.huerta@gsk.com. 3. Servicio de Neumología, Hospital Municipal de Badalona, Badalona, Barcelona, España. 4. Servicio de Documentación, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España.
Abstract
OBJECTIVE: To estimate adherence to asthma treatment with inhaled corticosteroid in clinical daily practice, and its relationship with exacerbations, as well as its use of resources and costs. MATERIAL AND METHODS: An observational, retrospective study using the electronic medical records of the Badalona Health Service provider. The study included patients≥15 years old with a confirmed diagnosed of asthma, and who initiated treatment with an inhaled corticosteroid between January 2010 and December 2011. The follow-up period was 24 months. Adherence to treatment was measured using the medication possession ratio. Two groups were established: adherent (ADH; medication possession ratio≥80%) and non-adherent (non-ADH; medication possession ratio<80%) patients. The main demographic and clinical variables, including exacerbations, were collected, along with the healthcare and non-healthcare (days of absence from work) resource use, and costs. RESULTS: The study included a total of 2,303 patients, with a mean age of 48.6 years, and 64.3% females. Just over half (52.6%) of the patients had moderate persistent asthma, and 51.0% of patients adhered to treatment. In the non-ADH patients, 63.4% suffered at least one exacerbation in the follow-up period, compared with 37.4% of the adherent patients (P<.001). The non-ADH patients also consumed a higher percentage of healthcare resources in Primary Care (22.5 vs. 17.4%), secondary care (3.3 vs. 2.5%), and emergency visits (1.4 vs. 0.2%) during the follow-up period (P<.001 in all cases). No statistical significance differences were observed in the days of absence from work. Mean annual cost of non-ADH patients was 1,431€/patient, compared with 722€/patient (P<.001) of ADH patients. CONCLUSION: Lack of adherence was associated with an increase in exacerbation rates, as well as healthcare resource consumption and costs.
OBJECTIVE: To estimate adherence to asthma treatment with inhaled corticosteroid in clinical daily practice, and its relationship with exacerbations, as well as its use of resources and costs. MATERIAL AND METHODS: An observational, retrospective study using the electronic medical records of the Badalona Health Service provider. The study included patients≥15 years old with a confirmed diagnosed of asthma, and who initiated treatment with an inhaled corticosteroid between January 2010 and December 2011. The follow-up period was 24 months. Adherence to treatment was measured using the medication possession ratio. Two groups were established: adherent (ADH; medication possession ratio≥80%) and non-adherent (non-ADH; medication possession ratio<80%) patients. The main demographic and clinical variables, including exacerbations, were collected, along with the healthcare and non-healthcare (days of absence from work) resource use, and costs. RESULTS: The study included a total of 2,303 patients, with a mean age of 48.6 years, and 64.3% females. Just over half (52.6%) of the patients had moderate persistent asthma, and 51.0% of patients adhered to treatment. In the non-ADH patients, 63.4% suffered at least one exacerbation in the follow-up period, compared with 37.4% of the adherent patients (P<.001). The non-ADH patients also consumed a higher percentage of healthcare resources in Primary Care (22.5 vs. 17.4%), secondary care (3.3 vs. 2.5%), and emergency visits (1.4 vs. 0.2%) during the follow-up period (P<.001 in all cases). No statistical significance differences were observed in the days of absence from work. Mean annual cost of non-ADH patients was 1,431€/patient, compared with 722€/patient (P<.001) of ADH patients. CONCLUSION: Lack of adherence was associated with an increase in exacerbation rates, as well as healthcare resource consumption and costs.
Authors: Antoni Sicras-Mainar; Belén Gómez Rodríguez; Susana Traseira-Lugilde; Toni Fernández-Sánchez; José Luis Velasco Garrido Journal: BMJ Open Date: 2022-04-20 Impact factor: 3.006