Adherence to inhalers in COPD patients

Michal Shani, Sophia Eilat-Tsanani, Doron Comaneshter, Michael Segel

Keywords: COPD, adherence, inhalers

Background:

Medication adherence is a key factor in medical treatment. Good adherence to medication improves health outcomes.

Research questions:

To explore long term adherence rates of various inhalers among patients with COPD in a real-world setting, and to identify patient characteristics related to good adherence to inhalers.

Method:

We conducted a population-based cohort study in Clalit Health Services, Israel.
Patients aged 48 -80 years with a diagnosis of COPD before 2017 were included. We analyzed adherence to 18 inhalers for COPD patients.
We included in the adherence analysis patients who filled at least one prescription per year in three consecutive years (2017-19). We analyzed all prescriptions that were filled for the medications from January 1st, 2018 to December 31st, 2018. We considered purchasing at least 7 monthly prescriptions during 2018 as "good adherence" (>50%) to inhalers.

Results:

32,155 COPD patients (37% women) were included in the study. The average age was 68.1±7.2. 75% of the patients had documented spirometry.
Only 14,796 (46%) used at least one of the inhalers included in the study. 10,877 (73.5%) used inhalers with corticosteroids, 13,200 (89.2%) used long acting beta agonists (LABA) inhalers 6,467 (43.7%) used long acting muscarinic agonists (LAMA) inhalers.
Good adherence rates to inhalers vary from 35% to 80%.Older patients, those with higher socioeconomic status, patients requiring hospitalization during the study period and patients who were vaccinated were more likely to be adherent.

Conclusions:

Different inhalers have different adherence rates. Treatment rates in COPD patients were low.

Points for discussion:

Different inhalers have different adherence rates. choosing the right inhaler can make a difference.

Most of out COPD patients do not get any treatment

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