Comparative adherence and persistence of single- and multiple-inhaler triple therapies among patients with chronic obstructive pulmonary disease in an English real-world primary care setting
dc.contributor.author | Halpin, DMG | |
dc.contributor.author | Rothnie, KJ | |
dc.contributor.author | Banks, V | |
dc.contributor.author | Czira, A | |
dc.contributor.author | Compton, C | |
dc.contributor.author | Wood, R | |
dc.contributor.author | Tritton, T | |
dc.contributor.author | Massey, O | |
dc.contributor.author | Wild, R | |
dc.contributor.author | Snowise, N | |
dc.contributor.author | Nikitin, K | |
dc.contributor.author | Sharma, R | |
dc.contributor.author | Ismaila, AS | |
dc.contributor.author | Vogelmeier, CF | |
dc.date.accessioned | 2023-06-21T08:40:14Z | |
dc.date.issued | 2022-09-24 | |
dc.date.updated | 2023-06-20T08:55:37Z | |
dc.description.abstract | PURPOSE: Triple therapy comprising a long-acting muscarinic antagonist, long-acting β2-agonist and inhaled corticosteroid is recommended for patients with chronic obstructive pulmonary disease (COPD) who continue to experience frequent exacerbations or symptoms whilst receiving dual therapy. Adherence and persistence to multiple-inhaler triple therapy (MITT) is known to be poor. This study assessed comparative adherence to single-inhaler triple therapy (SITT) versus MITT in a real-world setting in England. PATIENTS AND METHODS: This was a retrospective cohort study using linked primary care (Clinical Practice Research Datalink Aurum) and secondary care (Hospital Episode Statistics [HES] Admitted Patient Care) data to identify patients with COPD who were newly initiated on SITT or MITT between November 2017 and June 2019. Eligible patients were aged ≥35 years and had a forced expiratory volume in 1 second/forced vital capacity <0.7, linkage to HES and continuous registration with a general practitioner for 12 months pre- and 6 months post-initiation. Inverse probability of treatment weighting was used to balance baseline characteristics between cohorts. Adherence was measured using the proportion of days covered by days' supply of SITT or MITT prescriptions. Persistence was measured with a gap of >30 days between the end of a prescription and the following refill used to determine non-persistence. RESULTS: Overall, 4080 SITT and 6579 MITT users comprised the study cohort. After weighting, the baseline characteristics between the cohorts were comparable (absolute standardized mean difference <10%). SITT users had significantly higher adherence than MITT users at 6, 12, and 18 months post-initiation (p<0.001 for all comparisons). Median persistence was higher among SITT users than MITT users (5.09 months vs 0.99 months). CONCLUSION: Patients with COPD in England initiating SITT had significantly better adherence and persistence compared with MITT initiators. These improvements continued at least 18 months following treatment initiation. | en_GB |
dc.description.sponsorship | GlaxoSmithKlein | en_GB |
dc.format.extent | 2417-2429 | |
dc.identifier.citation | Vol. 17, pp. 2417-2429 | en_GB |
dc.identifier.doi | https://doi.org/10.2147/COPD.S370540 | |
dc.identifier.grantnumber | 208114 | en_GB |
dc.identifier.uri | http://hdl.handle.net/10871/133445 | |
dc.identifier | ORCID: 0000-0003-2009-4406 (Halpin, David MG) | |
dc.language.iso | en | en_GB |
dc.publisher | Dove Press | en_GB |
dc.relation.url | https://www.ncbi.nlm.nih.gov/pubmed/36185170 | en_GB |
dc.relation.url | http://www.cprd.com | en_GB |
dc.relation.url | https://digital.nhs.uk/data-and-information/data-tools-and-services/data-services/hospital-episodestatistics | en_GB |
dc.rights | © 2022 Halpin et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms. php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). | en_GB |
dc.subject | COPD | en_GB |
dc.subject | Clinical Practice Research Datalink | en_GB |
dc.subject | Hospital Episode Statistics | en_GB |
dc.subject | MITT | en_GB |
dc.subject | SITT | en_GB |
dc.subject | proportion of days covered | en_GB |
dc.title | Comparative adherence and persistence of single- and multiple-inhaler triple therapies among patients with chronic obstructive pulmonary disease in an English real-world primary care setting | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2023-06-21T08:40:14Z | |
dc.identifier.issn | 1176-9106 | |
exeter.place-of-publication | New Zealand | |
dc.description | This is the final version. Available from Dove Press via the DOI in this record. | en_GB |
dc.description | Data Sharing Statement: The data analyzed in this publication are derived from the Clinical Practice Research Datalink (www.cprd.com) and Hospital Episode Statistics database (https://digital.nhs.uk/data-and-information/data-tools-and-services/data-services/hospital-episodestatistics). Authors had access to the study data for the purposes of this work only. Data were accessed through an existing GSK license to address the prespecified research questions only. Therefore, the data cannot be broadly disclosed or made publicly available at this time. Access to each database can be requested via the respective websites. | en_GB |
dc.identifier.eissn | 1178-2005 | |
dc.identifier.journal | International Journal of Chronic Obstructive Pulmonary Disease | en_GB |
dc.rights.uri | https://creativecommons.org/licenses/by-nc/3.0/ | en_GB |
dcterms.dateAccepted | 2022-09-12 | |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2022-09-24 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2023-06-21T08:32:56Z | |
refterms.versionFCD | VoR | |
refterms.dateFOA | 2023-06-21T08:40:18Z | |
refterms.panel | Unspecified | en_GB |
refterms.dateFirstOnline | 2022-09-24 |
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php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the
work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For
permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).