Impact of multiple-dose versus single-dose inhaler devices on COPD patients' persistence with long-acting beta(2)-agonists: A dispensing database analysis

Job F. M. van Boven*, Joost J. van Raaij, Ruben van der Galiën, Maarten J. Postma, Thys van der Molen, P. N. Richard Dekhuijzen, Stefan Vegter

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

12 Citaten (Scopus)
154 Downloads (Pure)


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 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.

Originele taal-2English
Aantal pagina's6
TijdschriftPrimary Care Respiratory Medicine
StatusPublished - 2-okt-2014

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