Journal Article

Evaluation of Adherence and Persistence to Triple Therapy in Patients with COPD: A German Claims Data Study

Ismaila, Afisi, Claussen, Jing, Schultze, Michael, Richter, Lena, Beeh, Kai-Michael, Kossack, Nils, Noorduyn, Stephen, Vogelmeier, Claus, Requena, Gema, Compton, Chris

2024

Overview

Triple therapy (long-acting muscarinic antagonist/long-acting β -agonist/inhaled corticosteroid) is recommended for patients with chronic obstructive pulmonary disease (COPD) who experience recurrent exacerbations. Multiple-inhaler triple therapy (MITT) is associated with poor adherence and persistence. This study assessed comparative adherence and persistence to single-inhaler triple therapy (SITT) versus MITT among patients with COPD in a real-world setting in Germany. This retrospective analysis using the WIG2 benchmark database identified patients with COPD newly initiating triple therapy with MITT or SITT (fluticasone furoate/umeclidinium/vilanterol [FF/UMEC/VI] or formoterol/beclomethasone/glycopyrronium bromide [FOR/BDP/GLY]) November 2017-June 2019. Eligible patients were ≥35 years with 1 year's continual insurance prior to triple therapy initiation and no previous record of triple therapy. Inverse probability of treatment weighting was used to balance baseline characteristics. Adherence was measured using proportion of days covered (PDC) at 6, 12, and 18 months post-treatment initiation; persistence (time until treatment discontinuation) was measured at 6, 12, and 18 months, with a gap of >30 days used to define non-persistence. Of 5710 patients included in the analysis (mean age 66 years), 71.4% initiated MITT and 28.6% initiated SITT (FF/UMEC/VI: 41.4%; FOR/BDP/GLY: 58.6%). Mean PDC was higher among SITT versus MITT users at all time points; at each time point, mean PDC was highest among FF/UMEC/VI users. During the first 6 months following treatment initiation, higher adherence was exhibited by FF/UMEC/VI (29%) and FOR/BDP/GLY (19%) users versus MITT users. Over the entire observation period, FF/UMEC/VI users had the highest proportion of persistent patients; at 18 months, 16.5% of FF/UMEC/VI users were persistent versus 2.3% of MITT users. Patients initiating SITT in Germany had significantly higher adherence and persistence compared with patients initiating MITT over 6 to 18 months following treatment initiation. Among SITT, FF/UMEC/VI users had the highest proportion of adherence and persistence.

• Publisher: Dove Medical Press Limited,Dove Medical Press Ltd,Dove Press,Dove,Dove Medical Press
• Subject: Administration, Inhalation / Administrative Claims, Healthcare / Adrenergic beta-2 Receptor Agonists - administration & dosage / Aged / Arthritis / Benzyl Alcohols - administration & dosage / Benzyl Alcohols - therapeutic use / Bronchodilator Agents - administration & dosage / Chlorobenzenes - administration & dosage / Chlorobenzenes - therapeutic use / Chronic obstructive pulmonary disease / Cognitive ability / comparative / Comparative analysis / Corticosteroids / COVID-19 / Databases, Factual / Dementia / Drug Combinations / Drug dosages / Drug Therapy, Combination / Female / Germany / Glycopyrrolate - administration & dosage / Health insurance / Humans / Inhalers / Lung - drug effects / Lung - physiopathology / Lung diseases / Lung diseases, Obstructive / Male / Medication Adherence / Middle Aged / multiple- or single-inhaler triple therapy / Muscarinic Antagonists - administration & dosage / Nebulizers and Vaporizers / new-user / Objectives / Original Research / Pandemics / Patient compliance / Pharmaceutical industry / proportion of days covered / Pulmonary Disease, Chronic Obstructive - diagnosis / Pulmonary Disease, Chronic Obstructive - drug therapy / Pulmonary Disease, Chronic Obstructive - physiopathology / Quinuclidines - administration & dosage / real-world analysis / Respiratory agents / Retrospective Studies / Time Factors / treatment discontinuation / Treatment Outcome