未经证实:维持药物依从性欠佳与哮喘预后不良相关。这项研究检查了单吸入器吸入皮质类固醇(ICS)/长效β2激动剂(LABA)的依从性和哮喘相关结局。
UNASSIGNED:这项针对哮喘患者的回顾性观察性研究使用了IQVIAPharMetricsPlus(2014年1月1日至2019年3月31日)的数据。包括的患者年龄为18岁,并且在之前有12个月的连续资格,和180天随访后,索引日期。Adherencewasmeasuredasproportionofdaysrecovered([PDC]adherentalof0.8;non-adherental<0.8)eachquarter,在随后的每个季度测量结果。终点为哮喘相关的总体和严重(住院/急诊科[ED]就诊)急性加重,抢救药物的使用,以及与哮喘相关的医疗资源利用和成本。回归模型评估了依从性和结果之间的关联,控制重复测量和基线特征的差异。
未经评估:总的来说,纳入50,037例患者(平均年龄45.3岁;平均随访23.3个月)。粘附患者总体上不太可能出现与哮喘相关的情况(调整后比值比[aOR]95%置信区间[CI]:0.942[0.890,0.998];p=0.041),或严重加重(aOR[95%CI]:0.778[0.691,0.877];p<0.001)每季度与非粘附患者。粘附患者的严重加重率较低(调整后的比率[aRR][95%CI]:0.792[0.702,0.893];p<0.001),但总体加重率(aRR[95%CI]:0.993[0.945,1.044];p=0.783)与非粘附患者相似。PDC每增加20%,使用救护药物的几率较低(aOR[95%CI]短效β2激动剂:0.991[0.985,0.996];p=0.001;口服皮质类固醇:0.988[0.982,0.995];p<0.001)。坚持患者每季度就诊ED的可能性较小(aOR[95%CI]:0.775[0.680,0.883];p<0.001),每增加20%PDC住院几率较低(aOR[95%CI]:0.930[0.881,0.982];p=0.009)。在大多数措施中,坚持患者的费用较低。
UASSIGNED:这项现实世界的研究强调了ICS/LABA在哮喘中的短期临床和经济效益,特别是在减少严重恶化。
UNASSIGNED: Suboptimal adherence to maintenance medication has been associated with poor outcomes in asthma. This study examined single-inhaler inhaled corticosteroid (ICS)/long-acting β2 agonist (LABA) adherence and asthma-related outcomes.
UNASSIGNED: This retrospective observational study of patients with asthma initiating ICS/LABA used data from IQVIA PharMetrics Plus (1 January 2014-31 March 2019). Patients included were ⩾18 years old and had ⩾12 months continuous eligibility before, and ⩾180 days follow-up after, the index date. Adherence was measured as proportion of days covered ([PDC] adherent ⩾ 0.8; non-adherent <0.8) each quarter, with outcomes measured each subsequent quarter. Endpoints were asthma-related overall and severe (inpatient/emergency department [ED] visit) exacerbations, rescue medication use, and asthma-related healthcare resource utilization and costs. Regression models evaluated associations between adherence and outcomes, controlling for repeated measures and differences in baseline characteristics.
UNASSIGNED: Overall, 50,037 patients were included (mean age 45.3 years; mean follow-up 23.3 months). Adherent patients were less likely to experience asthma-related overall (adjusted odds ratio [aOR] 95% confidence interval [CI]: 0.942 [0.890, 0.998]; p = 0.041), or severe exacerbations (aOR [95% CI]: 0.778 [0.691, 0.877]; p < 0.001) per quarter versus non-adherent patients. Adherent patients had lower severe exacerbation rates (adjusted rate ratio [aRR] [95% CI]: 0.792 [0.702, 0.893]; p < 0.001) but similar overall exacerbation rates (aRR [95% CI]: 0.993 [0.945, 1.044]; p = 0.783) versus non-adherent patients. The odds of rescue medication use were lower per 20% PDC increase (aOR [95% CI] short-acting β2 agonist: 0.991 [0.985, 0.996]; p = 0.001; oral corticosteroid: 0.988 [0.982, 0.995]; p < 0.001). Adherent patients were less likely to visit EDs per quarter (aOR [95% CI]: 0.775 [0.680, 0.883]; p < 0.001) and odds of hospitalization were lower per 20% PDC increase (aOR [95% CI]: 0.930 [0.881, 0.982]; p = 0.009). Across most measures, adherent patients incurred lower costs.
UNASSIGNED: This real-world study highlights the short-term clinical and economic benefits of ICS/LABA adherence in asthma, particularly in reducing severe exacerbations.