Suppr超能文献

慢性阻塞性肺疾病(COPD)患者中COPD药物依从性与其他慢性疾病药物之间的关联。

Association between adherence to medications for COPD and medications for other chronic conditions in COPD patients.

作者信息

Dhamane Amol D, Schwab Phil, Hopson Sari, Moretz Chad, Annavarapu Srinivas, Burslem Kate, Renda Andrew, Kaila Shuchita

机构信息

Health Economics and Outcomes Research, Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, CT.

Comprehensive Health Insights Inc, Louisville.

出版信息

Int J Chron Obstruct Pulmon Dis. 2016 Dec 22;12:115-122. doi: 10.2147/COPD.S114802. eCollection 2017.

Abstract

BACKGROUND

Patients with COPD often have multiple comorbidities requiring use of multiple medications, and adherence rates for maintenance COPD (mCOPD) medications are already known to be suboptimal. Presence of comorbidities in COPD patients, and use of medications used to treat those comorbidities (non-COPD medications), may have an adverse impact on adherence to mCOPD medications.

OBJECTIVE

The objective of the study was to evaluate the association between non-adherence to mCOPD medications and non-COPD medications in COPD patients.

METHODS

COPD patients were identified using a large administrative claims database. Selected patients were 40-89 years old and continuously enrolled for 12 months prior to and 24 months after the first identified COPD diagnosis (index date) during January 1, 2009 to December 31, 2010. Patients were required to have ≥1 prescription for a mCOPD medication within 365 days of the index date and ≥1 prescription for one of 12 non-COPD medication classes within ±30 days of the first COPD prescription. Adherence (proportion of days covered [PDC]) was measured during 365 days following the first COPD prescription. The association between non-adherence (PDC <0.8) to mCOPD and non-adherence to non-COPD medications was determined using logistic regression, controlling for baseline patient characteristics.

RESULTS

A total of 14,117 patients, with a mean age of 69.9 years, met study criteria. Of these, 40.9% were males and 79.2% were non-adherent to mCOPD medications with a mean PDC of 0.47. Non-adherence to mCOPD medications was associated with non-adherence to 10 of 12 non-COPD medication classes (odds ratio 1.38-1.78, all <0.01).

CONCLUSION

Adherence to mCOPD medications is low. Non-adherence (or adherence) to mCOPD medications is positively related to non-adherence (or adherence) to non-COPD medications, implying that the need to take medications prescribed for comorbid conditions does not adversely impact adherence to mCOPD medications.

摘要

背景

慢性阻塞性肺疾病(COPD)患者常常患有多种合并症,需要使用多种药物,而且已知COPD维持治疗(mCOPD)药物的依从率并不理想。COPD患者合并症的存在以及用于治疗这些合并症的药物(非COPD药物)的使用,可能会对mCOPD药物的依从性产生不利影响。

目的

本研究的目的是评估COPD患者中mCOPD药物不依从与非COPD药物之间的关联。

方法

使用一个大型管理索赔数据库识别COPD患者。入选患者年龄在40 - 89岁之间,在2009年1月1日至2010年12月31日期间,在首次确诊COPD(索引日期)之前连续登记12个月,之后连续登记24个月。患者在索引日期的365天内需要有≥1份mCOPD药物处方,并且在首次COPD处方的±30天内需要有≥1份12种非COPD药物类别之一的处方。在首次COPD处方后的365天内测量依从性(覆盖天数比例[PDC])。使用逻辑回归确定mCOPD不依从(PDC <0.8)与非COPD药物不依从之间的关联,并对患者基线特征进行控制。

结果

共有14117名患者符合研究标准,平均年龄为69.9岁。其中,40.9%为男性,79.2%的患者mCOPD药物依从性差,平均PDC为0.47。mCOPD药物不依从与12种非COPD药物类别中的10种不依从相关(比值比为1.38 - 1.78,均<0.01)。

结论

mCOPD药物的依从性较低。mCOPD药物的不依从(或依从)与非COPD药物的不依从(或依从)呈正相关,这意味着治疗合并症所开药物的需求不会对mCOPD药物的依从性产生不利影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/28ad/5191849/d78c5b23e918/copd-12-115Fig1.jpg

相似文献

1
Association between adherence to medications for COPD and medications for other chronic conditions in COPD patients.
Int J Chron Obstruct Pulmon Dis. 2016 Dec 22;12:115-122. doi: 10.2147/COPD.S114802. eCollection 2017.
2
Association of chronic obstructive pulmonary disease maintenance medication adherence with all-cause hospitalization and spending in a Medicare population.
Am J Geriatr Pharmacother. 2012 Jun;10(3):201-10. doi: 10.1016/j.amjopharm.2012.04.002. Epub 2012 Apr 21.
4
An evaluation of early medication use for COPD: a population-based cohort study.
Int J Chron Obstruct Pulmon Dis. 2016 Dec 7;11:3101-3108. doi: 10.2147/COPD.S123643. eCollection 2016.
5
Development and validation of a drug adherence index for COPD.
J Manag Care Spec Pharm. 2021 Feb;27(2):198-209. doi: 10.18553/jmcp.2021.27.2.198.
7
Long-acting bronchodilator use after hospitalization for COPD: an observational study of health insurance claims data.
Int J Chron Obstruct Pulmon Dis. 2014 May 3;9:431-9. doi: 10.2147/COPD.S59322. eCollection 2014.
8
Treatment burden, clinical outcomes, and comorbidities in COPD: an examination of the utility of medication regimen complexity index in COPD.
Int J Chron Obstruct Pulmon Dis. 2017 Oct 6;12:2929-2942. doi: 10.2147/COPD.S136256. eCollection 2017.
10
The importance of inhaler devices: the choice of inhaler device may lead to suboptimal adherence in COPD patients.
Int J Chron Obstruct Pulmon Dis. 2015 Oct 29;10:2335-45. doi: 10.2147/COPD.S90155. eCollection 2015.

引用本文的文献

2
Investigating effectiveness of adherence of long-acting bronchodilator in chronic obstructive pulmonary disease with influenza infection.
Heliyon. 2024 Jul 27;10(15):e35367. doi: 10.1016/j.heliyon.2024.e35367. eCollection 2024 Aug 15.
3
Methods to assess COPD medications adherence in healthcare databases: a systematic review.
Eur Respir Rev. 2023 Sep 27;32(169). doi: 10.1183/16000617.0103-2023. Print 2023 Sep 30.
4
Up-to-date guidance towards improving medication adherence in patients with chronic obstructive pulmonary disease.
Expert Rev Respir Med. 2023 Jul-Dec;17(7):539-546. doi: 10.1080/17476348.2023.2239708. Epub 2023 Jul 28.
7
Individual trajectory-based care for COPD: getting closer, but not there yet.
ERJ Open Res. 2021 Dec 13;7(4). doi: 10.1183/23120541.00451-2021. eCollection 2021 Oct.
8
Adherence to Inhaled Therapy in Patients with COPD Associated to Pneumoconiosis.
Int J Chron Obstruct Pulmon Dis. 2021 Sep 27;16:2697-2706. doi: 10.2147/COPD.S327686. eCollection 2021.

本文引用的文献

1
Deaths: preliminary data for 2008.
Natl Vital Stat Rep. 2010 Dec;59(2):1-52.
3
Chronic obstructive pulmonary disease among adults--United States, 2011.
MMWR Morb Mortal Wkly Rep. 2012 Nov 23;61(46):938-43.
4
Undertreatment of COPD: a retrospective analysis of US managed care and Medicare patients.
Int J Chron Obstruct Pulmon Dis. 2012;7:1-9. doi: 10.2147/COPD.S27032. Epub 2012 Jan 18.
7
Comparing adherence and persistence across 6 chronic medication classes.
J Manag Care Pharm. 2009 Nov-Dec;15(9):728-40. doi: 10.18553/jmcp.2009.15.9.728.
8
The economic burden of chronic obstructive pulmonary disease (COPD) in a U.S. Medicare population.
Respir Med. 2008 Sep;102(9):1248-56. doi: 10.1016/j.rmed.2008.04.009. Epub 2008 Jul 11.
9
Refill adherence by the elderly for asthma/chronic obstructive pulmonary disease drugs dispensed over a 10-year period.
J Clin Pharm Ther. 2007 Dec;32(6):603-11. doi: 10.1111/j.1365-2710.2007.00866.x.
10
The significance of compliance and persistence in the treatment of diabetes, hypertension and dyslipidaemia: a review.
Int J Clin Pract. 2008 Jan;62(1):76-87. doi: 10.1111/j.1742-1241.2007.01630.x. Epub 2007 Nov 5.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验