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Ann Am Thorac Soc. 2015 Feb;12(2):161-6. doi: 10.1513/AnnalsATS.201410-459OC.

Primary adherence to controller medications for asthma is poor.

Author information

1
1 Center for Child Health Care Studies, Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School.

Abstract

RATIONALE:

Few previous studies have evaluated primary adherence (whether a new prescription is filled within 30 d) to controller medications in individuals with persistent asthma.

OBJECTIVE:

To compare adherence to the major controller medication regimens for asthma.

METHODS:

This was a retrospective cohort study of enrollees from five large health plans. We used electronic medical data on patients of all ages with asthma who had experienced an asthma-related exacerbation in the prior 12 months. We studied adherence measures including proportion of days covered and primary adherence (first prescription filled within 30 d).

MEASUREMENTS AND MAIN RESULTS:

Our population included 69,652 subjects who had probable persistent asthma and were prescribed inhaled corticosteroids (ICSs), leukotriene antagonists (LTRAs), or ICS/long-acting β-agonists (ICS/LABAs). The mean age was 37 years and 58% were female. We found that 14-20% of subjects who were prescribed controller medicines for the first time did not fill their prescriptions. The mean proportion of days covered was 19% for ICS, 30% for LTRA, and 25% for ICS/LABA over 12 months. Using multivariate logistic regression, subjects prescribed LTRA were less likely to be primary adherent than subjects prescribed ICS (odds ratio, 0.82; 95% confidence interval, 0.74-0.92) or ICS/LABA (odds ratio, 0.88; 95% confidence interval, 0.80-0.97). Black and Latino patients were less likely to fill the prescription compared with white patients.

CONCLUSIONS:

Adherence to controller medications for asthma is poor. In this insured population, primary adherence to ICSs was better than to LTRAs and ICS/LABAs. Adherence as measured by proportion of days covered was better for LTRAs and ICS/LABAs than for ICSs.

KEYWORDS:

adherence; asthma; inhaled corticosteroids; leukotriene antagonists; medications

PMID:
25569765
PMCID:
PMC4342835
DOI:
10.1513/AnnalsATS.201410-459OC
[Indexed for MEDLINE]
Free PMC Article

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