Evidence map›Paper›PMID 29209982›Full record

ArticleClinical drug investigation2018

Adherence to Inhaled Medications and its Effect on Healthcare Utilization and Costs Among High-Grade Chronic Obstructive Pulmonary Disease Patients.

Jee-Ae Kim, Min Kyoung Lim, Kunil Kim, JuHee Park, Chin Kook Rhee

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Article in Clinical drug investigation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Methods to assess COPD medications adherence in healthcare databases: a systematic review.European respiratory review : an official journal of the European Respiratory Society · 2023
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  15. Korean COPD Patients Can Get Satisfaction.Journal of Korean medical science · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jee-Ae KimHealth Insurance Review and Assessment Service, Pharmaceutical Policy Research Team, Research Institution, Wonju, South Korea.
Min Kyoung LimDepartment of Nursing, Shinhan University, Seoul, South Korea.
Kunil KimDepartment of Radiology, Pusan National University, Yangsan Hospital, Yangsan, South Korea.
JuHee ParkHealth Insurance Review and Assessment Service, Pharmaceutical Policy Research Team, Research Institution, Wonju, South Korea.
Chin Kook RheeDivision of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seochogu, Seoul, 06591, South Korea. chinkook77@gmail.com.ORCID http://orcid.org/0000-0003-4533-7937

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAdherence to inhaled medication regimens affects chronic obstructive pulmonary disease (COPD) prognosis and quality of life, and reduces the use of healthcare services, resulting in cost savings.

objectivesTo examine the effects of adherence to inhaled medication regimens on healthcare utilization and costs in high-grade COPD patients.

methodsWe performed an observational retrospective cohort study using a longitudinal data set from the Korean Health Insurance Review and Assessment Service (2008-2013) containing healthcare services' information for 50 million beneficiaries. The study population was high-grade COPD patients. "Adherent" was defined as a patient attaining a medication possession ratio (MPR) ≥ 80%. We estimated the effects of adherence on the use of intensive care units (ICUs) and emergency rooms (ERs) using a multivariate logistic regression, and estimated the effects on costs (all-cause and COPD-related) using a generalized linear model, with adjustment for patient sociodemographic characteristics, health status, and comorbidities.

resultsOf 9086 high-grade COPD patients, adherence declined from 34.7 to 22.3% over 4 years. Adherence was inversely associated with use of ICUs and costs, and this association got stronger as the adherence period lengthened. Over the 4-year period, the adherent group had a lower likelihood of using ICUs [odds ratio (OR) = 0.74, 95% confidence interval (CI) 0.60-0.91] than the non-adherent group. Similarly, the adherent group had a 10.4% lower all-cause cost (p < 0.001) and an 11.7% lower COPD-related cost (p < 0.0001) versus the non-adherent group.

conclusionsAdherence reduces healthcare utilization and costs, so adherence is not only clinically effective but also economically efficient. However, less than one-quarter of this population remained adherent over the 4-year period, suggesting that strategies are needed to improve adherence.

Indexed as

Medication AdherenceAdministration, InhalationAdultAgedCost SavingsEmergency Service, HospitalFemaleHealth Care CostsHumansIntensive Care UnitsLinear ModelsLogistic ModelsMaleMiddle AgedPatient Acceptance of Health CarePulmonary Disease, Chronic Obstructive

Identifiers

PMID29209982

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.