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Ann Allergy Asthma Immunol. 2006 Sep;97(3):402-8.

Medication compliance and disease exacerbation in patients with asthma: a retrospective study of managed care data.

Author information

1
Global Health Outcomes, Analytica International, New York, New York 10016, USA. lstern@AnalyticaIntl.com

Abstract

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.

PMID:
17042149
DOI:
10.1016/S1081-1206(10)60808-3
[Indexed for MEDLINE]

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