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Adherence and persistence with fluticasone propionate/salmeterol combination therapy.
Bruce G Bender1, Alex Pedan, Laleh T Varasteh
1Department of Pediatrics, National Jewish Medical and Research Center, Denver, CO 80206, USA. benderb@njc.org
The Journal of Allergy and Clinical Immunology
|October 13, 2006
Summary
Medication adherence for fluticasone propionate/salmeterol combination (FSC) is low, with most patients filling only one prescription within a year. This highlights a significant gap between actual patient behavior and treatment guidelines.
Area of Science:
- Pharmacology and Pharmacoepidemiology
- Respiratory Medicine
- Health Services Research
Background:
- Pharmacy refill data offers insights into national medication-taking behaviors.
- Understanding adherence to combination inhalers is crucial for managing respiratory conditions.
Purpose of the Study:
- To assess fluticasone propionate/salmeterol combination (FSC) adherence using a national pharmacy database.
- To identify factors influencing refill adherence for FSC.
Main Methods:
- A 12-month adherence and persistence analysis was conducted on 5504 patients using FSC.
- Data was collected from a nationwide pharmacy chain, tracking medication fills from the initial prescription date.
Main Results:
- Patients, on average, had medication to cover only 22.2% of days.
- Over half of patients refilled a 30-day prescription only once annually.
- Higher adherence correlated with male sex, age >35, comorbidities, specific copay ranges, prior beta2-agonist use, and higher FSC dosage.
Conclusions:
- Adherence to FSC in real-world practice is significantly lower than reported in clinical trials.
- Most adults discontinue controller medication after a single fill, diverging from treatment guidelines.
- There is a critical need to revise treatment guidelines and educational strategies for providers and patients.
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