Abstract
Background: Adherence to asthma medication is often suboptimal, leading to suboptimal control of the disease. Insight in adherence patterns in real life is important to improve asthma management.
Objectives: To study adherence patterns of inhaled corticosteroids (ICS) using group‐based trajectory models and investigate risk factors for poor adherence in asthmatic patients.
Methods: A retrospective cohort study (2007–2016) in asthmatic patients, ≥5 years old in 2 primary care databases: IPCI (NL) and THIN (UK). Asthma was defined as ≥1 asthma disease code in combination with ≥2 prescriptions of respiratory drugs in one year. Prescriptions were retrieved by ATC code from patient records. We used group‐based trajectory analysis to model 4 adherence trajectories of ICS within 2 years after asthma diagnosis, for children (5–17 years) and adults (≥18 years) separately. Good adherence was defined as ≥80% of days covered by a prescription. Patient characteristics at baseline were compared between trajectory groups.
Results: In total, 12,524 adults and 3,152 children from the IPCI database and 47,700 adults and 22,807 children from the THIN database were included. In all databases a trajectory of ‘high adherent’, ‘decreasing adherent’, ‘increasing adherent’ and ‘poor adherent’ patients were observed. In children, ‘high adherent’ patients were significantly younger and had more often eczema and rhinitis or nasal polyposis than ‘poor adherent’ patients. In adults, ‘high adherent’ patients were significantly older, had more often diabetes and GERD, less often rhinitis and were less often smokers than ‘poor adherent’ patients.
Conclusions: Conclusion: We observed different adherence trajectories with distinct patient characteristics. Targeting patients at risk for poor adherence is important to improve asthma management.
Objectives: To study adherence patterns of inhaled corticosteroids (ICS) using group‐based trajectory models and investigate risk factors for poor adherence in asthmatic patients.
Methods: A retrospective cohort study (2007–2016) in asthmatic patients, ≥5 years old in 2 primary care databases: IPCI (NL) and THIN (UK). Asthma was defined as ≥1 asthma disease code in combination with ≥2 prescriptions of respiratory drugs in one year. Prescriptions were retrieved by ATC code from patient records. We used group‐based trajectory analysis to model 4 adherence trajectories of ICS within 2 years after asthma diagnosis, for children (5–17 years) and adults (≥18 years) separately. Good adherence was defined as ≥80% of days covered by a prescription. Patient characteristics at baseline were compared between trajectory groups.
Results: In total, 12,524 adults and 3,152 children from the IPCI database and 47,700 adults and 22,807 children from the THIN database were included. In all databases a trajectory of ‘high adherent’, ‘decreasing adherent’, ‘increasing adherent’ and ‘poor adherent’ patients were observed. In children, ‘high adherent’ patients were significantly younger and had more often eczema and rhinitis or nasal polyposis than ‘poor adherent’ patients. In adults, ‘high adherent’ patients were significantly older, had more often diabetes and GERD, less often rhinitis and were less often smokers than ‘poor adherent’ patients.
Conclusions: Conclusion: We observed different adherence trajectories with distinct patient characteristics. Targeting patients at risk for poor adherence is important to improve asthma management.
| Original language | English |
|---|---|
| Pages (from-to) | 457-457 |
| Journal | Pharmacoepidemiology and Drug Safety |
| Volume | 28 |
| Issue number | S2 |
| Publication status | Published - Aug 2019 |