Izquierdo José Luis, Paredero José Manuel, Piedra Raul
Department of Pneumology, Hospital Universitario de Guadalajara, Guadalajara, Spain.
Department of Pharmacy, Guadalajara Integrated Care Management, Guadalajara, Spain.
Int J Chron Obstruct Pulmon Dis. 2016 Feb 10;11:289-93. doi: 10.2147/COPD.S96948. eCollection 2016.
The aim of this study was to assess the degree of adherence for two standard regimens for administrating anticholinergic drugs (12 and 24 hours) in patients with chronic obstruction of the airflow and to establish whether the use of a once-daily dose improves the level of treatment adherence.
We used long-acting anticholinergics (LAMAs) as a study variable, and included the entire health area of Castile-La Mancha, numbering 2,100,998 inhabitants, as the study population. We analyzed a total of 16,446 patients who had been prescribed a LAMA between January 1, 2013 and December 31, 2013. The follow-up period, based on a centralized system of electronic prescription management, was extended until December 2014.
During 2013, the medication collected was 7.4%-10.7% higher than indicated by labeling. This was very similar for all LAMAs, irrespective of the patient's sex, the molecule, the device, and the drug dosage. We did not observe seasonal variations in the consumption of LAMAs, nor did we detect differences between prescription drugs for once-daily (every 24 hours) versus twice-daily (every 12 hours) administration, between the different molecules, or between different types of inhalers for the same molecule. The results were similar in 2014.
The principal conclusion of this study is that, in an area with a centralized management system of pharmacological prescriptions, adherence to treatment with LAMAs is very high, irrespective of the molecules or inhalation device. We did not find that patients who used twice-daily medication had a lower adherence.
本研究旨在评估慢性气流阻塞患者使用两种标准抗胆碱能药物给药方案（12小时和24小时）的依从程度，并确定每日一次给药是否能提高治疗依从性。
我们将长效抗胆碱能药物（LAMA）作为研究变量，并将卡斯蒂利亚-拉曼恰整个卫生区域（居民人数为2,100,998）纳入研究人群。我们分析了2013年1月1日至2013年12月31日期间共16,446例开具了LAMA处方的患者。基于集中式电子处方管理系统，随访期延长至2014年12月。
2013年期间，所收集的药物比标签所示高出7.4%-10.7%。所有LAMA的情况都非常相似，无论患者性别、药物分子、给药装置和药物剂量如何。我们未观察到LAMA使用的季节性变化，也未发现每日一次（每24小时）给药与每日两次（每12小时）给药的处方药之间、不同药物分子之间或同一药物分子的不同类型吸入器之间存在差异。2014年的结果相似。
本研究的主要结论是，在一个具有药理处方集中管理系统的地区中，无论药物分子或吸入装置如何LAMA治疗的依从性都非常高。我们没有发现每日两次用药的患者依从性较低。
