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Persistence with inhaled corticosteroid therapy in daily practice.
N S Breekveldt-Postma1, C M J M Gerrits, J W J Lammers
1The PHARMO Institute, PO Box 85.222, Utrecht 3508 AE, The Netherlands. pharmo@pharmo.nl
Respiratory Medicine
|August 12, 2004
Summary
Inhaled corticosteroid (ICS) persistence is poor, with only 18% of new users continuing treatment for a full year. Improving adherence to ICS is crucial for maximizing treatment benefits in obstructive lung diseases.
Area of Science:
- Pulmonary Medicine
- Pharmacoeconomics
- Real-world Evidence
Background:
- Inhaled corticosteroids (ICS) are a cornerstone therapy for obstructive lung diseases.
- Understanding patient persistence with ICS is vital for optimizing treatment outcomes and healthcare resource utilization.
Purpose of the Study:
- To quantify the persistence rates of new inhaled corticosteroid (ICS) users in a real-world setting.
- To identify key factors influencing ICS treatment adherence.
Main Methods:
- Retrospective cohort study utilizing the Dutch PHARMO system, including medication and hospital admission records.
- Identification of new ICS users between 1994-2000, with persistence defined as days on treatment in the first year.
- Analysis of determinants of persistence from data recorded one year prior to ICS initiation.
Main Results:
- Approximately 50% of patients used ICS for less than 200 days; only 18% persisted for one year.
- Higher persistence was observed in patients with prior use of multiple respiratory medications, lower initial ICS doses, specialist initiation, prior hospitalization, and older age.
- One-year persistence reached 40% in patients with a history of multiple respiratory disease-related drug use.
Conclusions:
- ICS persistence rates in new users are suboptimal, indicating significant early treatment discontinuation.
- Interventions to prevent early ICS treatment cessation are necessary to ensure patients achieve the full therapeutic benefits of these medications.