For patients with chronic obstructive pulmonary disease (COPD), non-adherence to maintenance COPD (mCOPD) medications was positively associated with non-adherence to non-COPD medications, implying that treatment for comorbid conditions do not adversely impact adherence to mCOPD medications.
COPD patients frequently have multiple comorbidities which require several medications. This study, conducted by researchers at Boehringer Ingelheim, Comprehensive Health Insights and Humana, sought to uncover whether comorbid medication burden played a role in known suboptimal mCOPD medication adherence.
A total of 14,117 COPD patients taken from a large claims database were included in the study. Study patients were required to have at least 1 mCOPD medication prescription within 365 days of the index date and at least 1 of 12 non-COPD medication prescription within ±30 days of the first COPD prescription.Adherence (portion of days covered [PDC]) was measured during the year following the first COPD prescription.
Results showed that 79.2% of patients were non-adherent to mCOPD medications with a mean PDC of 0.47. Maintenance COPD medication non-adherence was positively associated with 10 of 12 non-COPD medication classes (odds ratio [OD] 1.38-1.78, P<0.01). This mutual non-adherence indicates that the need to take medications for comorbid conditions does not impact mCOPD medication adherence.
The authors speculated that there may be common factors for low adherence to the various treatments, such as lack of coordinated healthcare or behavioral and socioeconomic characteristics of the patient population.
Hypothesizing how adherence could be improved in this population, Andrew Renda, MD, MPH, co-author of the study, said, “Rather than focus on the number and type of comorbidities with COPD, holistic adherence improvement efforts should address access, affordability, and most importantly, education on how these medications improve symptoms and quality of life while reducing the risk of exacerbations.”
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