Adherence with tobramycin inhaled solution and health care utilization
Becky A Briesacher1, Alexandra L Quittner, Lisa Saiman
1University of Massachusetts Medical School and Meyers Primary Care Institute, Worcester, MA, USA.
BMC Pulmonary Medicine
|January 22, 2011
Summary
High adherence to tobramycin inhalation solution (TIS) in cystic fibrosis (CF) care is linked to fewer hospitalizations and varied healthcare costs. Optimal TIS use may improve patient outcomes and resource management.
Area of Science:
- Pulmonary Medicine
- Pharmacoeconomics
- Healthcare Management
Background:
- Adherence to tobramycin inhalation solution (TIS) in cystic fibrosis (CF) care often deviates from clinical guidelines.
- Suboptimal TIS adherence can significantly influence overall healthcare utilization patterns.
Purpose of the Study:
- To evaluate the relationship between TIS adherence levels and healthcare utilization in CF patients.
- To analyze the impact of TIS adherence on hospitalization risk and associated costs.
Main Methods:
- Analysis of healthcare claims data from 2001-2006 for 804 individuals with CF and TIS prescriptions.
- Adherence categorized as low (≤2 cycles), medium (>2 to <4 cycles), and high (≥4 cycles) per year.
- Logistic regression used to assess hospitalization risk; Interquartile ranges (IQR) for healthcare costs.
Main Results:
- Only 7% of patients achieved high TIS adherence (≥4 cycles/year).
- High adherence was associated with a 60% reduced risk of hospitalization (aOR 0.40).
- High adherence correlated with lower outpatient service costs but higher prescription drug costs.
Conclusions:
- TIS utilization in routine CF care does not align with recommended guidelines.
- Adherence to TIS significantly impacts healthcare utilization, including hospitalization rates and costs.
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