TY - JOUR
T1 - Impact of multiple-dose versus single-dose inhaler devices on COPD patients' persistence with long-acting beta(2)-agonists
T2 - A dispensing database analysis
AU - van Boven, Job F. M.
AU - van Raaij, Joost J.
AU - van der Galiën, Ruben
AU - Postma, Maarten J.
AU - van der Molen, Thys
AU - Dekhuijzen, P. N. Richard
AU - Vegter, Stefan
PY - 2014/10/2
Y1 - 2014/10/2
N2 - BACKGROUND: With a growing availability of different devices and types of medication, additional evidence is required to assist clinicians in prescribing the optimal medication in relation to chronic obstructive pulmonary disease (COPD) patients' persistence with long-acting beta(2)-agonists (LABAs).AIMS: To assess the impact of the type of inhaler device (multiple-dose versus single-dose inhalers) on 1-year persistence and switching patterns with LABAs.METHODS: A retrospective observational cohort study was performed comparing a cohort of patients initiating multiple-dose inhalers and a cohort initiating single-dose inhalers. The study population consisted of long-acting bronchodilator naive COPD patients, initiating inhalation therapy with mono-LABAs (formoterol, indacaterol or salmeterol). Analyses were performed using pharmacy dispensing data from 1994 to 2012, obtained from the IADB.nl database. Study outcomes were 1-year persistence and switching patterns. Results were adjusted for initial prescriber, initial medication, dosing regimen and relevant comorbidities.RESULTS: In all, 575 patients initiating LABAs were included in the final study cohort. Among them, 475 (83%) initiated a multiple-dose inhaler and 100 (17%) a single-dose inhaler. Further, 269 (47%) initiated formoterol, 9 (2%) indacaterol and 297 (52%) salmeterol. There was no significant difference in persistence between users of multiple-dose or single-dose inhalers (hazard ratio: 0.98, 95% confidence interval: 0.76-1.26, P = 0.99). Over 80% re-started or switched medication.CONCLUSIONS: There seems no impact of inhaler device (multiple-dose versus single-dose inhalers) on COPD patients' persistence with LABAs. Over 80% of patients who initially seemed to discontinue LABAs, re-started their initial medication or switched inhalers or medication within 1 year.
AB - BACKGROUND: With a growing availability of different devices and types of medication, additional evidence is required to assist clinicians in prescribing the optimal medication in relation to chronic obstructive pulmonary disease (COPD) patients' persistence with long-acting beta(2)-agonists (LABAs).AIMS: To assess the impact of the type of inhaler device (multiple-dose versus single-dose inhalers) on 1-year persistence and switching patterns with LABAs.METHODS: A retrospective observational cohort study was performed comparing a cohort of patients initiating multiple-dose inhalers and a cohort initiating single-dose inhalers. The study population consisted of long-acting bronchodilator naive COPD patients, initiating inhalation therapy with mono-LABAs (formoterol, indacaterol or salmeterol). Analyses were performed using pharmacy dispensing data from 1994 to 2012, obtained from the IADB.nl database. Study outcomes were 1-year persistence and switching patterns. Results were adjusted for initial prescriber, initial medication, dosing regimen and relevant comorbidities.RESULTS: In all, 575 patients initiating LABAs were included in the final study cohort. Among them, 475 (83%) initiated a multiple-dose inhaler and 100 (17%) a single-dose inhaler. Further, 269 (47%) initiated formoterol, 9 (2%) indacaterol and 297 (52%) salmeterol. There was no significant difference in persistence between users of multiple-dose or single-dose inhalers (hazard ratio: 0.98, 95% confidence interval: 0.76-1.26, P = 0.99). Over 80% re-started or switched medication.CONCLUSIONS: There seems no impact of inhaler device (multiple-dose versus single-dose inhalers) on COPD patients' persistence with LABAs. Over 80% of patients who initially seemed to discontinue LABAs, re-started their initial medication or switched inhalers or medication within 1 year.
KW - OBSTRUCTIVE PULMONARY-DISEASE
KW - MEDICATION NONADHERENCE
KW - INHALATION TECHNIQUE
KW - ECONOMIC-IMPACT
KW - ADMIT SERIES
KW - ADHERENCE
KW - THERAPY
KW - ASTHMA
KW - POPULATION
KW - OUTCOMES
U2 - 10.1038/npjpcrm.2014.69
DO - 10.1038/npjpcrm.2014.69
M3 - Article
C2 - 25274453
VL - 24
JO - Primary Care Respiratory Medicine
JF - Primary Care Respiratory Medicine
SN - 2055-1010
M1 - 14069
ER -