Primary non-adherence to inhaled medications measured with e-prescription data from Poland
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(2020) 10:39 Kardas et al. Clin Transl Allergy https://doi.org/10.1186/s13601-020-00346-7
Open Access
RESEARCH
Primary non‑adherence to inhaled medications measured with e‑prescription data from Poland Grzegorz Kardas1 , Michał Panek1, Piotr Kuna1 and Przemysław Kardas2*
Abstract Background: Treatment adherence greatly influences the clinical outcomes in various fields of medicine, including management of asthma and COPD. With the recent implementation of a nationwide e-Health solutions in Poland, new and unique opportunities for studying primary non-adherence in asthma and COPD emerged. The aim was to study primary non-adherence to inhaled medications available in Poland indicated in asthma and/or COPD and analyse the impact of patients’ demographics and inhalers’ characteristics (dry powder inhalers (DPIs) vs metered dose inhalers (MDIs) and presence of a dosage counter) on primary non-adherence. Methods: A retrospective analysis of all e-prescriptions issued in Poland in 2018 (n = 119,880) from the national e-prescription pilot framework. Results: Primary non-adherence for inhalable medications reached 15.3%. It significantly differed among age groups—the lowest (10.8%) was in 75 + years-old patients, highest (18%) in 65–74 years-old patients. No gender differences in primary non-adherence were found. The highest non-adherence was observed for ICS + LABA combinations (18.86%). A significant difference was found between MDI and DPI inhalers and between inhalers with/without a dosage counter. Conclusions: Out of e-prescriptions for inhaled medications issued in 2018 in Poland, 15.3% were not redeemed. The degree of primary non-adherence was influenced by age, but not gender. Significant differences between MDIs and DPIs and between inhalers with/without a dosage counter were observed. Keywords: Inhaled medications, Inhalators, Asthma adherence, COPD adherence, Primary non-adherence, e-prescription Introduction Treatment adherence greatly influences the clinical outcomes in various fields of medicine. In general, the worse is the adherence, the worse are the health outcomes and patients’ quality of life [1]. It is also a major determinant of healthcare costs [2]. These effects also take place in the management of obstructive lung diseases—asthma *Correspondence: [email protected] 2 First Department of Family Medicine, Medical University of Lodz, Lodz, Poland Full list of author information is available at the end of the article
and chronic obstructive pulmonary disease (COPD). In course of these two conditions, the primary clinical role is attributed to inhaled medications, which are important in management of disease symptoms and natural course of the diseases. As asthma and COPD are frequent and most often chronic conditions, the key to their successful management comes with systematic drug use, particularly those inhaled. Specific drug selection depends on the diagnosis and indication, previous treatment response, disease severity, patient’s individual needs and preferences and various other pat
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